Factores pronósticos en metástasis pulmonares resecables de carcinoma colorrectal

Llarena, Alberto Muñoz; Revilla, Sergio Carrera; Laborda, Aitziber Gil-Negrete; Ferrer, Joaquín Pac; Galíndez, Ramón Barceló; Vivanco, Guillermo López

doi:10.1157/13106561

Cited by 19 publications

(2 citation statements)

References 29 publications

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“…Numerous studies have previously reported survival after lung metastasectomy for CRC [3, 4, 6, 15–19]. Our study demonstrated a patient 5-years OS of 54.3%, which was similar or slightly better than these previous reports.…”

Section: Discussionsupporting

confidence: 86%

“…Currently, it is accepted worldwide as superior to non-surgical treatments for improving survival in patients with confined lung metastasis, with a concept of semi-local metastases [2]. The overall 5-years survival after lung metastasectomy is reported to be 22 – 68%, with a trend towards improved survival since 2000 [3–7]. Several previous studies have analyzed the post-lung metastasectomy prognostic factors, but no consensus has been reached, because of differences in the study findings.…”

Section: Introductionmentioning

confidence: 99%

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Survival after initial lung metastasectomy for metastatic colorectal cancer in the modern chemotherapeutic era

et al. 2017

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BackgroundA clear survival benefit has been reported for lung metastasectomy for colorectal cancer, and several clinicopathological prognostic factors have been proposed in the past. However, clinical advances, such as chemotherapy and radiographic imaging, should have improved patient outcome and may have altered prognosticators. This study aimed to assess patient survival and determine prognostic factors for survival and recurrence in patients who underwent initial lung metastasectomy for colorectal cancer in the modern clinical era.MethodsClinicopathological data and outcomes of 59 patients who underwent curative initial lung metastasectomy for colorectal cancer from 2004 to 2012 at a single institution in Japan were retrospectively investigated. Survival was estimated using the Kaplan - Meier method, and Cox proportional hazards regression models were used to estimate the prognostic impacts of each variable in univariate and multivariate analysis.ResultsThe 5-years overall and disease-free survival rates were 54.3 and 40.6%, respectively. A disease-free interval < 24 months after colorectal cancer resection (P = 0.004) and a serum carcinoembryonic antigen ≥ 5.0 ng/mL before initial lung metastasectomy (P = 0.015) were independent predictors for poor overall survival. Moreover, the disease-free interval after colorectal cancer resection < 24 months (P = 0.010) and a colorectal cancer with N2 stage disease (P = 0.018) were independently associated with poor disease-free survival. On the other hand, the number of lung metastasis was not identified as a poor prognostic factor for both overall and disease-free survival.ConclusionsOur findings demonstrated similar or slightly better overall survival, and substantially favorable disease-free survival as compared with past reports. Poor prognostic factors for overall survival appeared not to differ from those of past studies, although this modern series did not determine the number of lung metastasis as a poor prognostic factor, which should be investigated in future studies. Moreover, initial lung metastasectomy is not expected to be a curable treatment for patients with both a short disease-free survival after colorectal cancer resection and colorectal cancers with N2 stage disease.

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