Details

Autor(en) / Beteiligte

• Riquet, Marc, MD, PhD
• Foucault, Christophe, MD
• Cazes, Aurélie, MD, PhD
• Mitry, Emmanuel, MD, PhD
• Dujon, Antoine, MD
• Le Pimpec Barthes, Françoise, MD, PhD
• Médioni, Jacques, MD, PhD
• Rougier, Philippe, MD, PhD

Titel

Pulmonary Resection for Metastases of Colorectal Adenocarcinoma

Ist Teil von

• The Annals of thoracic surgery, 2010-02, Vol.89 (2), p.375-380

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2010

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background Surgery is a safe and effective treatment for patients with lung metastases from colorectal carcinoma. Combining chemotherapy and surgery seems to prolong survival time after metastasectomy. Our purpose was to review the effectiveness of surgery with time and evolving managements. Methods The records of 127 patients were retrospectively analyzed. The characteristics of primary cancer, lung metastases, resections, and associated therapy were studied according to their incidence on survival. Results There were 74 male and 53 female patients (mean age, 65 years); 223 operations were performed and 314 metastases were resected. Completeness of surgery (n = 117) was the main factor for prolonged survival (5- and 10-year survival, 41% and 27%, versus 0%). There was no factor of significantly better prognosis, but a tendency to higher survival rates was observed in cases of single metastasis, in patients undergoing several lung operations, and in patients in whom liver metastases were previously removed. Three of 7 patients with mediastinal lymph node involvement survived more than 5 years; 58 patients were operated on before January 2000, and 59 between January 2000 and December 2007. Five-year survival rates were 35.1% versus 63.5%, respectively ( p = 0.0096), probably related to better selection with modern workup, more frequent use of chemotherapy, and repeated pulmonary resections. Conclusions Different treatment protocols were reported in the literature and in our series with time, resulting in better survival rates and a more aggressive surgical tendency. The beneficial role of such combined therapy justifies further research, including prospective trials.