Surgical resection of synchronous and metachronous lung and liver metastases of colorectal cancers
Annals of Surgical Treatment and Research
; : 82-89, 2017.
Article
in En
| WPRIM
| ID: wpr-8204
Responsible library:
WPRO
ABSTRACT
PURPOSE: Surgical resection of isolated hepatic or pulmonary metastases of colorectal cancer is an established procedure, with a 5-year survival rate of about 50%. However, the role of surgical resections in patients with both hepatic and pulmonary metastases is not well established. We aimed to analyze overall survival of these patients and associated factors. METHODS: Data retrospectively collected from 66 patients who underwent both hepatic and pulmonary metastasectomy after colorectal cancer surgery from August 2002 through August 2013 were analyzed. In univariate analysis, the log-rank test compared patient survival between groups. P < 0.1 was considered indicative of significance. Multivariate analysis of the significance data using a Cox proportional hazard model identified factors associated with overall survival. The synchronous group (n = 57) was defined as patients who had metastasectomy within 3 months from primary colorectal cancer surgery. The remaining nine patients constituted the metachronous group. RESULTS: Median follow-up was 126 months from the primary colorectal cancer surgery. The 5-year survival was 73.4%. There was no difference in overall survival between the synchronous and metachronous groups, consistent with previous studies. Distribution (involving one hemiliver or both, P = 0.010 in multivariate analysis) of liver metastases and multiplicity of the pulmonary metastasis (P = 0.039) were predictors of poor prognosis. CONCLUSION: Sequential or simultaneous resection of both hepatic and pulmonary metastasis of colorectal cancer resulted in good long-term survival in selected patients. Thus, an aggressive surgical approach and multidisciplinary decision making with surgeons seems to be justified.
Key words
Full text:
1
Database:
WPRIM
Main subject:
Prognosis
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Colorectal Neoplasms
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Proportional Hazards Models
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Multivariate Analysis
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Survival Rate
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Retrospective Studies
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Follow-Up Studies
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Decision Making
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Metastasectomy
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Surgeons
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Annals of Surgical Treatment and Research
Year:
2017
Document type:
Article