[Resection of lung metastases from colorectal cancer]

Abstract

Objectives: To evaluate clinically relevant prognostic factors and to define a subgroup of patients who would most benefit from resection of lung metastases.

Patients and method: Between July 1978 and April 2004, 125 patients with pulmonary metastases from colorectal cancer who underwent lung resections were prospectively followed-up. The median follow-up was 32.4 +/- 3.2 months. Patients with no evidence of extrathoracic recurrence, no more than three metastases on either side, and adequate cardiorespiratory function were eligible for surgery. The most frequent procedure was lobectomy. Univariate and multivariate analyses were performed, with a value of p = 0.05.

Results: A total of 54.4% of the patients were men. The median age was 53.04 +/- 11.5 years. Survival rates at 3 and 5 years were 47% and 27% respectively. The independent prognostic factors identified were size of metastases and extent of resection. Subgroup analysis defined two statistically relevant prognostic groups: patients with metastases sized 3.75 +/- 2.3 cm or less with a disease-free interval of more than 10 months and patients with larger metastases and a shorter disease-free interval.

Conclusions: Subgroup analysis provided criteria for the selection of patients for resection of lung metastases from colorectal cancer and differentiated between those at high and low risk of early tumor progression.