Pulmonary Resection of Metastatic Colorectal Adenocarcinoma

Mansel, J. Keith; Zinsmeister, Alan R.; Pairolero, Peter C.; Jett, James R.

doi:10.1378/chest.89.1.109

Cited by 107 publications

(48 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Prolonged survival after surgery for pulmonary metastases from CRC has been documented, with the 5-year survival ranging from 10 to 50% [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. However, the main cause of death after pulmonary resection from CRC is tumor recurrence, which involves the lung in approximately 50% of cases [5].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection for pulmonary metastasis is an effective treatment for patients with pulmonary metastasis from CRC, and previous studies have suggested several prognostic factors affecting survival after a resection of pulmonary metastasis from CRC [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. However, there are discrepancies between the results of these studies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Metastatic Tumor Doubling Time Is an Independent Predictor of Intrapulmonary Recurrence after Pulmonary Resection of Solitary Pulmonary Metastasis from Colorectal Cancer

et al. 2008

View full text Add to dashboard Cite

Background: Several investigators have previously reported the prognostic factors affecting survival after a surgical resection of pulmonary metastasis from colorectal cancer (CRC). However, there have so far been no reports describing prognostic factors related to the tumor doubling time (TDT) of pulmonary metastasis. Methods: 65 patients with solitary pulmonary metastasis from CRC were retrospectively reviewed and the prognostic factors after pulmonary resection including TDT were analyzed. Results: The 5-year intrapulmonary recurrence-free survival rates after pulmonary resection was 59.9%. The TDT of pulmonary metastasis (<100 vs. 100 days or higher) was only a significant prognostic factor in intrapulmonary recurrence after the pulmonary resection (p = 0.0006). The 5-year overall survival rate after the pulmonary resection was 64.2%. Preoperative serum carcinoembryonic antigen (CEA) level (<5 vs. 5 ng/ml or higher) was the only significant prognostic factor in overall survival after the pulmonary resection (p = 0.0049). The overall survival of patients whose TDT was 100 days or higher tended to be better than that of patients whose TDT was <100 (p = 0.0631). Conclusions: The TDT of solitary pulmonary metastasis is a significant prognostic factor after surgery for solitary pulmonary metastasis from CRC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metastatic Tumor Doubling Time Is an Independent Predictor of Intrapulmonary Recurrence after Pulmonary Resection of Solitary Pulmonary Metastasis from Colorectal Cancer

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Patients with peritoneal carcinomatosis or extrahepatic disease at multiple sites did tend to have a worse survival than patients with single-site extrahepatic disease [98]. In contrast, patients with only pulmonary metastasis as the type of extrahepatic disease had a particularly good outcome following complete metastasectomy of both liver and lung disease [99,101,113,114].…”

Section: Extrahepatic Diseasementioning

confidence: 98%

Expanding Criteria for Resectability of Colorectal Liver Metastases

2008

View full text Add to dashboard Cite

After completing this course, the reader will be able to:1. Identify the criteria for hepatic resection of colorectal metastases.2. Describe strategies for expanding the number of patients who may potentially benefit from hepatic resection.3. List the factors associated with poor prognosis following hepatic resection.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTSurgical resection is the treatment of choice in patients with colorectal liver metastases, with 5-year survival rates reported in the range of 40%-58%. Over the past 10 years, there has been an impetus to expand the criteria for defining resectability for patients with colorectal metastases. In the past, such features as the number of metastases (three to four), the size of the tumor lesion, and a mandatory 1-cm margin of resection dictated who was "resectable." More recently, the criteria for resectability have been expanded to include any patient in whom all disease can be removed with a negative margin and who has adequate hepatic volume/reserve. Specifically, instead of resectability being defined by what is removed, decisions concerning resectability now center around what will remain after resection. Under this new paradigm, the number of patients with resectable disease can be expanded by increasing/preserving hepatic reserve (e.g., portal vein embolization, two-stage hepatectomy), combining resection with ablation, and decreasing tumor size (preoperative chemotherapy). The criteria for resectability have also expanded to include patients with extrahepatic disease. Rather than being an absolute contraindication to surgery, patients with both intra-and extrahepatic disease should potentially be considered for resection based on strict selection criteria. The expansion of criteria for resectability of colorectal liver metastases requires a much more nuanced and sophisticated approach to the patient with advanced disease. A therapeutic approach that includes all aspects of multidisciplinary and multimodality care is required to select and treat this complex group of patients. The Oncologist 2008;13:51-64

show abstract

“…Specifically, Pulitanò et al [46] noted that the location of EHD was associated with prognosis, as patients having pulmonary metastasis had the best prognosis and patients with retroperitoneal/aortocaval lymph node metastasis had the worse prognosis. Pulmonary metastasectomy has been demonstrated to prolong survival in selected patients and has a clear benefit in patients with solitary or oligometastatic disease [47][48][49] . Specifically, 5-year survival after pulmonary resection of colorectal metastasis has been reported to be as high as 48.0% [50] .…”

Section: Extrahepatic Diseasementioning

confidence: 99%

Surgery for colorectal liver metastases: The evolution of determining prognosis

Spolverato

Ejaz

Azad

et al. 2013

WJGO

View full text Add to dashboard Cite

Despite improvements in the multi-modality treatment of colorectal liver metastasis (CRLM), survival after resection remains varied. Determining prognosis after surgical resection has historically been predicated on preoperative clinicopathological factors such as primary tumor stage, carcinoembryonic antigen levels, number of liver metastases, presence of extrahepatic disease, as well as other factors. While scoring systems have been developed by combining certain preoperative factors, these have been inconsistent in accurately determining prognosis. There has been increasing interest in the use of biologic and molecular markers to predict prognosis following CRLM. The role of markers such as KRAS, BRAF, p53, human telomerase reverse transcriptase, thymidylate synthase, Ki-67, and hypoxia inducible factor-1α and their correlation with accurately predicting survival after surgical resection have been supported by several studies. Furthermore, other elements such as pathological response to chemotherapy and the presence of circulating tumor cells have shown promise in accurately determining prognosis after resection for colorectal liver metastasis. We herein review past, present, and possible future markers of prognosis among colorectal cancer patients with liver metastasis undergoing resection with curative intent.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Colorectal; Metastasis; Prognosis; Risk score; Molecular markers; Outcomes Core tip: Historically, prognosis after resection has been largely assessed based on preoperative clinicopathologic features. Data validating the prognostic value of patient and tumor specific factors have been mixed, with many recent studies showing these scoring systems to correlate poorly with survival. Rather, there has been an emerging interest in biological or molecular markers of prognosis to more effectively assess patient prognosis after resection of colorectal liver metastasis. In this review, we discuss past, present, and possible future markers of prognosis among colorectal cancer patients with liver metastasis undergoing resection with curative intent.

show abstract

Pulmonary Resection of Metastatic Colorectal Adenocarcinoma

Cited by 107 publications

References 4 publications

Metastatic Tumor Doubling Time Is an Independent Predictor of Intrapulmonary Recurrence after Pulmonary Resection of Solitary Pulmonary Metastasis from Colorectal Cancer

Metastatic Tumor Doubling Time Is an Independent Predictor of Intrapulmonary Recurrence after Pulmonary Resection of Solitary Pulmonary Metastasis from Colorectal Cancer

Expanding Criteria for Resectability of Colorectal Liver Metastases

Surgery for colorectal liver metastases: The evolution of determining prognosis

Contact Info

Product

Resources

About