Survival Analysis of Resection of Lung Metastases From Colorectal Cancer

Poce, Roberto Mongil; Navarrete, Carlos Pagés; Navarrete, José Antonio Ruiz; Fernández, Javier Roca; Sánchez, Ricardo Arrabal; Doménech, Agustín Benítez; de Rota Avecilla, Antonio Fernández; Bermúdez, José Luis Fernández

doi:10.1016/S1579-2129(09)72154-8

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Abstract

Introduction

The publication of the International Registry of Lung Metastases (IRLM) in 1997 was a turning point in favor of surgical resection of lung metastases. Prognostic groups were defined according to resectability, number of metastases, and disease-free interval. The objective of this study was to determine survival in patients who underwent resection of lung metastases from colorectal carcinoma and to evaluate how applicable the prognostic factors established by the IRLM are in this specific patient group.

Patients and Methods

Patients with lung metastases from colorectal carcinoma who underwent resection between January 1, 2000, and November 30, 2006, were retrospectively analyzed. Survival was calculated using the Kaplan-Meier method, with log-rank comparisons between groups.

Results

Survivals at 1, 3, 5, and 6 years was 92%, 75%, 54%, and 43%, respectively. The main finding was that 3-year survival was better in patients who underwent atypical resection of the metastasis (75%) than those who required lobectomy (55%). There were no significant differences in survival in terms of number of lung metastases resected or disease-free interval.

Conclusions

Survival in patients requiring lobectomy for resection of lung metastases from colorectal carcinoma was worse than in those who underwent atypical resection. The number of metastases and disease-free interval may be questionable prognostic factors in the case of lung metastases from colorectal carcinoma.

Keywords:

Lung metastasis

Colorectal carcinoma

Surgery

Resumen

Introducción

La publicación del Registro Internacional de Metástasis Pulmonares (IRLM, de International Registry of Lung Metastases) en 1997 supuso un punto de inflexión a favor de la cirugía de resección de metástasis pulmonares (MP). Se establecieron grupos pronósticos en función de la resecabilidad, el número de MP y el intervalo libre de enfermedad (ILE). El objetivo de este trabajo ha sido determinar la supervivencia de los pacientes intervenidos con resección de MP de carcinoma colorrectal y evaluar la aplicabilidad de los factores pronósticos establecidos por el IRLM a este grupo concreto de pacientes.

Pacientes y métodos

Se ha realizado un trabajo retrospectivo recogiendo los casos de MP de carcinoma colorrectal intervenidos entre el 1 de enero de 2000 y el 30 de noviembre de 2006. Para calcular la supervivencia se empleó el método de Kaplan-Meier con el test de rangos logarítmicos.

Resultados

La supervivencia a 1; 3; 5, y 6 años fue del 92, el 75, el 54 y el 43%, respectivamente. Como principal hallazgo, se observó que los pacientes a quienes se realizó resección atípica de las metástasis tuvieron mayor supervivencia que aquellos que necesitaron lobectomía: un 75% de supervivencia a los 3 años frente al 55%, respectivamente. No se encontraron diferencias significativas de supervivencia en cuanto al número de MP resecadas ni en cuanto al ILE.

Conclusiones

Los pacientes que requieren lobectomía para la resección de MP de carcinoma colorrectal presentan peor supervivencia que aquellos a los que se realiza resección atípica. El número de metástasis y el ILE pueden ser factores pronósticos cuestionables en el caso de MP de carcinoma colorrectal.

Palabras clave:

Metástasis pulmonar

Carcinoma colorectal

Tratamiento quirúrgico

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