Predicting survival after pulmonary metastasectomy for colorectal cancer: previous liver metastases matter
| Autor: | John Robert, Vincent Olivier Ott, Philippe Morel, Pascal Gervaz, Thomas V. Perneger, Ulrich Landes, Gilles Mentha |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms Colorectal cancer medicine.medical_treatment lcsh:Surgery Risk Assessment Cohort Studies Pneumonectomy Predictive Value of Tests Cause of Death Research article medicine Hepatectomy Humans Thoracotomy Survival analysis Aged Probability Retrospective Studies Aged 80 and over business.industry Liver Neoplasms Retrospective cohort study lcsh:RD1-811 General Medicine Middle Aged medicine.disease Survival Analysis Surgery Logistic Models Female Metastasectomy Colorectal Neoplasms business Wedge resection (lung) |
| Zdroj: | BMC Surgery BMC Surgery, Vol 10, Iss 1, p 17 (2010) |
| ISSN: | 1471-2482 |
| DOI: | 10.1186/1471-2482-10-17 |
| Popis: | Background Few patients with lung metastases from colorectal cancer (CRC) are candidates for surgical therapy with a curative intent, and it is currently impossible to identify those who may benefit the most from thoracotomy. The aim of this study was to determine the impact of various parameters on survival after pulmonary metastasectomy for CRC. Methods We performed a retrospective analysis of 40 consecutive patients (median age 63.5 [range 33-82] years) who underwent resection of pulmonary metastases from CRC in our institution from 1996 to 2009. Results Median follow-up was 33 (range 4-139) months. Twenty-four (60%) patients did not have previous liver metastases before undergoing lung surgery. Median disease-free interval between primary colorectal tumor and development of lung metastases was 32.5 months. 3- and 5-year overall survival after thoracotomy was 70.1% and 43.4%, respectively. In multivariate analysis, the following parameters were correlated with tumor recurrence after thoracotomy; a history of previous liver metastases (HR = 3.8, 95%CI 1.4-9.8); and lung surgery other than wedge resection (HR = 3.0, 95%CI 1.1-7.8). Prior resection of liver metastases was also correlated with an increased risk of death (HR = 5.1, 95% CI 1.1-24.8, p = 0.04). Median survival after thoracotomy was 87 (range 34-139) months in the group of patients without liver metastases versus 40 (range 28-51) months in patients who had undergone prior hepatectomy (p = 0.09). Conclusion The main parameter associated with poor outcome after lung resection of CRC metastases is a history of liver metastases. |
| Databáze: | OpenAIRE |
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