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. 2022 Jul 8;52(7):735-741.
doi: 10.1093/jjco/hyac045.

Role of resection for extrahepatopulmonary metastases of colon cancer

Takuya Mishina  1 , Kay Uehara  1 , Atsushi Ogura  1 , Yuki Murata  1 , Toshisada Aiba  1 , Takashi Mizuno  1 , Yukihiro Yokoyama  1 , Tomoki Ebata  1
Affiliations

Role of resection for extrahepatopulmonary metastases of colon cancer

Takuya Mishina et al. Jpn J Clin Oncol. .

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Jpn J Clin Oncol. 2022 Nov 3;52(11):1358. doi: 10.1093/jjco/hyac156. Jpn J Clin Oncol. 2022. PMID: 36124846 Free PMC article. No abstract available.

Abstract

Background: Although surgical resection for liver or lung metastases of colorectal cancer has been widely accepted, the use of this approach for extrahepatopulmonary metastases remains debatable due to the systemic nature of the disease. The aim of this study was to clarify the utility of resection along with perioperative chemotherapy for patients with extrahepatopulmonary metastases of colon cancer.

Methods: This is a retrospective single-arm study at a single institution. Forty-two patients with resectable extrahepatopulmonary metastases who underwent metastasectomy with curative intent between 2009 and 2018 at Nagoya University Hospital were retrospectively analyzed. The primary outcomes measured were overall and relapse-free survival.

Results: The most common metastatic site was the peritoneum (n = 31), followed by the distant lymph nodes (n = 10), ovary (n = 1) and spleen (n = 1), with overlaps. Preoperative and postoperative chemotherapies were administered to 22 and 8 patients, respectively; the remaining 14 patients received surgery alone. R0 resection was achieved in 36 patients (85.7%). The 5-year overall survival and 3-year relapse-free survival rates were 58.6% and 33.8%, respectively. In the univariate analysis, R1 resection was associated with a poor relapse-free survival rate (P = 0.02). In the multivariate analysis, the absence of perioperative chemotherapy was an independent risk factor for poor overall survival rates (P = 0.02).

Conclusions: Surgical resection benefited selected patients with extrahepatopulmonary metastases with favorable long-term survival outcomes. Surgery alone without systemic chemotherapy is likely to bring poor outcome; therefore, preoperative induction might be promising to keep up with chemotherapy.

Keywords: chemotherapy; colon cancer; distant lymph nodes metastases; extrahepatopulmonary metastases; peritoneal dissemination.

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