Thorac cardiovasc Surg 2017; 65(07): 560-566
DOI: 10.1055/s-0036-1579699
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Forty-Two Years' Experience with Pulmonary Resections of Metastases from Colorectal Cancer

Wojciech Dudek1, 2, Waldemar Schreiner1, 2, Werner Hohenberger1, 3, Peter Klein1, 3, Horia Sirbu1, 2
  • 1Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
  • 2Division of Thoracic Surgery, University Hospital Erlangen, Erlangen, Germany
  • 3Department of Surgery, University Hospital Erlangen, Erlangen, Germany
Further Information

Publication History

02 December 2015

29 January 2016

Publication Date:
10 March 2016 (eFirst)

Abstract

Background Pulmonary metastasectomy is a commonly performed surgery in patients with controlled metastatic colorectal cancer (CRC). We reviewed our long-term single institution experience with lung resections for colorectal metastases to assess the factors influencing patient survival.

Materials and Methods A cohort of 220 patients (138 men and 82 women; median age, 59 years) who underwent complete pulmonary metastasectomy for CRC with curative intent between 1972 and 2014 was retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on patient survival was assessed.

Results Two postoperative inhospital deaths occurred. The median interoperative interval was 26 months. The overall 5-year survival rate after pulmonary metastasectomy was 49.4%. In univariable analysis, bilateral pulmonary metastases (log rank p = 0.02), multiple metastases (log rank p = 0.005), and stage IV UICC (the International Union Against Cancer) CRC at the time of initial presentation (log rank p = 0.008) were significantly associated with poor outcome. Multivariable Cox analysis demonstrated that stage IV CRC (p = 0.02) and multiple metastases (p = 0.0019) were statistically significant predictors of survival after the pulmonary metastasectomy. There was no significant difference in survival between patients with high versus low preoperative carcinoembryonic antigen serum level (p = 0.149), high versus low preoperative carbohydrate antigen 19-9 serum level (p = 0.291), and primary tumor location in rectum versus colon (p = 0.845).

Conclusion Patients with unilateral metastasis and stages I to III primary tumor benefited most from pulmonary metastasectomy for CRC.