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. 2021 Dec 30:13:9429-9437.
doi: 10.2147/CMAR.S341543. eCollection 2021.

Anatomical Resection Improves Disease-Free Survival After Lung Metastasectomy of Colorectal Cancer

Tianyu Liu #  1 , Wenju Chang #  1   2 , Hao Wang #  3 , Qi Lin #  1   2 , Ye Wei  1   2 , Wentao Tang  1 , Yu Liu  1 , Yijiao Chen  1 , Zhengchuan Niu  1 , Yudong Jiang  1 , Li Ren  1   2 , Jianmin Xu  1   2
Affiliations

Anatomical Resection Improves Disease-Free Survival After Lung Metastasectomy of Colorectal Cancer

Tianyu Liu et al. Cancer Manag Res. .

Abstract

Purpose: This study aimed to evaluate the role of anatomical resection (AR) in lung metastasectomy (LM) of colorectal cancer (CRC) and to investigate clinically relevant prognostic factors.

Patients and methods: The medical records of 350 consecutive patients who underwent LM of CRC from 2011 to 2019 were reviewed. The patients were designated into AR group (lobectomy and segmentectomy), and non-anatomical resection (NAR) group (wedge resection), respectively. Kaplan-Meier method was used to analyze disease-free survival (DFS), pulmonary-specific disease-free survival (PDFS) and overall survival (OS). Cox proportional hazards regression model was performed to analyze the factors associated with DFS, PDFS and OS.

Results: A total of 92 (31.2%) patients were enrolled in AR group and 203 (68.8%) in non-anatomical resection (NAR) group. AR significantly improved the 3-year DFS (64.1% vs 46.8%, HR 0.587, 95% CI 0.397-0.867, P = 0.007) and PDFS (75.0% vs 60.1%, HR 0.565, 95% CI 0.356-0.899, P = 0.016) compared with NAR. However, the extent of resection did not significantly impact the 3-year OS (AR 92.4% vs NAR 85.7%, HR 0.511, 95% CI 0.224-1.165, P = 0.110). In multivariate analysis, AR was identified as a protective factor for DFS (HR 0.576, 95% CI 0.356-0.934, P = 0.025) and PDFS (HR 0.631, 95% CI 0.409-0.973, P = 0.037). Preoperative abnormal CA19-9 was identified as the only prognostic factor for OS.

Conclusion: AR was superior to NAR for DFS and PDFS after LM from CRC.

Keywords: lobectomy; prognosis; pulmonary metastasis; wedge resection.

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Conflict of interest statement

There was no financial and personal relationship with other people and organizations that could inappropriately influence this work. The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of the included patients.
Figure 2
Figure 2
Kaplan–Meier survival according to the type of resection of lung metastases. (A) disease-free survival, (B) pulmonary-specific disease-free survival, (C) overall survival.
See this image and copyright information in PMC

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