Surgical resection of synchronous and metachronous lung and liver metastases of colorectal cancers.
10.4174/astr.2017.92.2.82
- Author:
Shinseok JEONG
1
;
Jin Seok HEO
;
Jin Young PARK
;
Dong Wook CHOI
;
Seong Ho CHOI
Author Information
1. Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Jinseok.heo@samsung.com
- Publication Type:Original Article
- Keywords:
Colorectal cancer;
Liver metastasis;
Lung metastasis;
Synchronous metastasis
- MeSH:
Colorectal Neoplasms*;
Decision Making;
Follow-Up Studies;
Humans;
Liver*;
Lung*;
Metastasectomy;
Multivariate Analysis;
Neoplasm Metastasis*;
Prognosis;
Proportional Hazards Models;
Retrospective Studies;
Surgeons;
Survival Rate
- From:Annals of Surgical Treatment and Research
2017;92(2):82-89
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Surgical resection of isolated hepatic or pulmonary metastases of colorectal cancer is an established procedure, with a 5-year survival rate of about 50%. However, the role of surgical resections in patients with both hepatic and pulmonary metastases is not well established. We aimed to analyze overall survival of these patients and associated factors. METHODS: Data retrospectively collected from 66 patients who underwent both hepatic and pulmonary metastasectomy after colorectal cancer surgery from August 2002 through August 2013 were analyzed. In univariate analysis, the log-rank test compared patient survival between groups. P < 0.1 was considered indicative of significance. Multivariate analysis of the significance data using a Cox proportional hazard model identified factors associated with overall survival. The synchronous group (n = 57) was defined as patients who had metastasectomy within 3 months from primary colorectal cancer surgery. The remaining nine patients constituted the metachronous group. RESULTS: Median follow-up was 126 months from the primary colorectal cancer surgery. The 5-year survival was 73.4%. There was no difference in overall survival between the synchronous and metachronous groups, consistent with previous studies. Distribution (involving one hemiliver or both, P = 0.010 in multivariate analysis) of liver metastases and multiplicity of the pulmonary metastasis (P = 0.039) were predictors of poor prognosis. CONCLUSION: Sequential or simultaneous resection of both hepatic and pulmonary metastasis of colorectal cancer resulted in good long-term survival in selected patients. Thus, an aggressive surgical approach and multidisciplinary decision making with surgeons seems to be justified.
