%0 Journal Article
%T Predicting survival after pulmonary metastasectomy for colorectal cancer: previous liver metastases matter
%A Ulrich Landes
%A John Robert
%A Thomas Perneger
%A Gilles Mentha
%A Vincent Ott
%A Philippe Morel
%A Pascal Gervaz
%J BMC Surgery
%D 2010
%I BioMed Central
%R 10.1186/1471-2482-10-17
%X 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.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).The main parameter associated with poor outcome after lung resection of CRC metastases is a history of liver metastases.Resection of hepatic metastases from colorectal cancer (CRC) has yielded 5-year survival rates ranging from 25% to 50% [1,2]. Similarly, resection of lung metastases from CRC has yielded 5-year survival rates ranging from 20% up to 60% in large series [3,4]. Based on these encouraging results, many surgeons have expanded the indications for resecting metastatic CRC, and there is nowadays growing pressure to perform lung metastasectomy, even in asymptomatic CRC patients. The issue therefore is to select the patients with pulmonary metastases who are good candidate for surgical therapy with a curative intent. Unfortunately, it is currently not possible to do so - hence the necessity for surgeons to preoperatively identify clinico-pathological parameters pred
%U http://www.biomedcentral.com/1471-2482/10/17