Surgical resection of pulmonary metastases from colorectal cancer: 11 years of experiences

Abstract

Objective: To analyze the benefits and prognostic factors after surgical resection of pulmonary metastases from colorectal cancer (CRC).

Methods: From Jan. 2004 to Jan. 2015, continuous 88 cases diagnosed with pulmonary metastases from CRC, including 15 cases of synchronous metastases and 73 metachronous metastases, were analyzed in the retrospective study.

Results: All of these 88 cases underwent curative pulmonary resection including 8 cases of simultaneous surgery. The one-year, three-year and five-year survival of the 88 cases were 93.4%, 60.2% and 35.7%, respectively. 63 patients just have one metastasis, and 25 patients have more than one metastasis. Additionally, the one-year, three-year and five-year survival was 98.1%, 70.2% and 40.3% respectively in one metastasis group, while 80.1%, 37.9% and 22.5% respectively in more than one metastasis group (p = 0.003). DFS of 37 metachronous metastases were equal or greater than 18 months, and DFS of 36 metachronous metastases were less than 18 months. The one-year, three-year and five-year survival was 97.8%, 77.9% and 41.4% respectively in the DFS≥18 month group, while 88.2%, 44.6% and 28.1% respectively in the DFS<18 month group (p = 0.01).

Conclusion: Surgical resection of pulmonary metastases from colorectal cancer can improve survival rate in selected patients. It seems that the number of metastases is an independence prognostic factor in surgical treatment. Furthermore, longer DFI implies longer survival for resectable CRC pulmonary metastases.

Fig 1. Though it seemed the CEA<5ng/ml group had a better behavior in survival than CEAastases.

Mected patients. I"5 months, and 36 months or moreated.

Fig 2. There was no statistical significance (p = 0.676) between synchronous metastasis patients metachronous metastasis patients.

Fig 3. Longer DFS means longer survival in metachronous pulmonary metastases patients (p = 0.011).

Fig 4. Patients with isolated pulmonary metastasis had longer survival than those whose metastases number were more than one (p = 0.003).