Surgical management in lung metastases from colorectal cancer.

BACKGROUND: Colorectal cancer is a non-aggressive slow-growing disease. Surgery is often considered for the management of metastases. Chemotherapeutical agents may offer tumor reduction but radical tumor remission can only be achieved by surgery. The aim of the present study was to show the evolution of patients with lung metastases from colorectal cancer, treated with surgery. PATIENTS AND METHODS: Five hundred and seventy-nine (male 327, female 252, median age 60 years [range 30-87 years], disease stage IV) patients with colorectal cancer were evaluated. Histology showed adenocarcinoma with 94% moderate differentiation. Sixty-six patients (11.40%) had only lung metastasis (single or multiple deposits). Of these 66 patients, 57 were treated with surgery (pneumonectomy, lobectomy or nodule excision) and in 52/57 (91.23%) the tumor was removed. RESULTS: In 29 patients (50.88%) the disease recurred 8 months after surgery, at the earliest; however, no recurrence was observed in 28 patients (49.12%) during 2-8 years of follow-up after the operation. Five-year survival was 32.69%. CONCLUSION: Metastectomy of lung metastasis from primary colorectal cancer may achieve long-term survival without recurrence in a large percentage of patients.

Effect of amiloride in human and sheep parietal pleura.

The fluid and solute transport properties of human parietal pleura were studied and compared with sheep parietal pleura in vitro. The pleura was mounted as a planar sheet between Ussing-type chambers. The results presented are the mean values of nine different experiments. The transepithelial electrical resistance (R(TE)) of both pleurae species was measured before and after the addition of amiloride in both sides of pleura. The R(TE) for human was 25.74 +/- 1.23 Ohm x cm(2), while for the sheep it was 38.18 +/- 0.83 Ohm x cm(2). The addition of amiloride to the serosal bathing solution increased the R(TE) of human pleura to 30.48 +/- 1.01 Ohm x cm(2) and sheep pleura to 40.32 +/- 0.82 Ohm x cm(2), while amiloride had no effect on the basolateral side. From the above, it is strongly suggested that the human pleura seems to be more leaky than sheep pleura. Although the R(TE) was increased in both pleurae, the elevation in human pleura was significantly higher, thus results from experiments in sheep pleura could only partly be extrapolated in human pleura.