Pulmonary Metastasectomy for Colorectal Carcinoma

Kwang-Ho Choi; Yang-Haeng Lee; Kyoung-Taek Park; Il-Yong Han; Young-Chul Yoon; Kwang-Hyun Cho

doi:10.6058/jlc.2010.9.2.91

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Choi, Lee, Park, Han, Yoon, and Cho: Pulmonary Metastasectomy for Colorectal Carcinoma

Original Article

J Lung Cancer 2010;9(2):91-96.

Published online: 10 January 2010

DOI: https://doi.org/10.6058/jlc.2010.9.2.91

Pulmonary Metastasectomy for Colorectal Carcinoma

Kwang-Ho Choi, M.D., Yang-Haeng Lee, M.D., Kyoung-Taek Park, M.D., Il-Yong Han, M.D., Young-Chul Yoon, M.D., Kwang-Hyun Cho, M.D.

Department of Thoracic and Cardio-vascular Surgery, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea

Address for correspondence Yang-Haeng Lee, M.D. Department of Thoracic and Cardio-vascular Surgery, Pusan Paik Hospital, Inje University College of Medicine, 633-165, Gaegeum 2-dong, Busanjin-gu, Busan 614-735, Korea Tel: 82-51-890-6834 Fax: 82-51-891-1297 E-mail: ctslee@inje.ac.kr

This work was supprted by the 2005 Inje University research Grant.

Received 26 August 2010 Revised 12 October 2010 Accepted 1 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Surgical resection is an important curative treatment for pulmonary metastases from colorectal adenocarcinoma. We analyzed the outcomes and the prognostic factors related to the post operative mortality after surgical resection for pulmonary metastases from colorectal adenocarcinoma.

Materials and Methods

Between January 1994 and December 2009, 28 patients underwent complete pulmonary resection of metastatic colorectal carcinoma. We performed a retrospective review of the patient's characteristics and the factors affecting survival. Survival was analyzed by the Kaplan-Meier method and comparison between groups was performed by a log-rank analysis.

Results

The median survival was 53.07 months (Kaplan-Meier method). The number of pulmonary metastases (p=0.0151) and a prethoracotomy carcinoembryonic antigen (CEA) level over 5 ng/mL (p=0.0217) were significantly related with survival.

Conclusion

The prethoracotomy CEA level and the number of metastases were significantly related with the survival rate. Resection of pulmonary metastatic lung lesion from colorectal cancer may improve the survival rate in a selected group of patients.

Keywords: Neoplasm metastasis, Colorectal neoplasm, Thoracic surgery

References

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Figures and Tables

Fig. 1.

Overall survival after curative pulmonary resection (n=28).

Fig. 2.

Survival of patients with elevated prethoracotomy carcinoembryonic antigen (CEA) vs. patients with normal prethoracotomy CEA (n=28, p=0.0217).

Fig. 3.

Survival of patients with number of pulmonary metastases (n=28, p=0.0151).

Table 1.

Patient’ s Characteristics

Variables	No. of patients (%)
Age	61.39 (44∼78 yr)
Sex
Male	19 (67.9)
Female	9 (32.1)
No. of pulmonary metastasis
1	26 (92.9)
2	2 (7.1)
Resection
Wedge resection	15 (53.6)
Segmentectomy	4 (14.3)
Lobectomy	9 (32.1)
Prethoracotomy CEA level
＜5 ng/mL	14 (50)
≥5 ng/mL	12 (42.8)
Uncheck	2 (7.2)
Chemotherapy
Postoperative	23 (82.1)
None	5 (17.9)
Metastatic lung lesion
Right	11 (39.3)
Left	17 (60.7)
Disease free interval
＜2 yr	10 (35.7)
≥2 yr	18 (64.3)

CEA: carcinoembryonic antigen.

Table 2.

Survival and Analysis of Prognostic Factors CEA Carcinoembryonic Antigen

	No. of patients	5-yr survival rate	p-value
Overall	28	58.36
Gender			0.1247
Male	19	47.4
Female	9	80.0
Age			0.92
＜60 yr	11	55.6
≥60 yr	17	62.5
Maximum tumor size			0.1672
＜2 cm	15	37.5
≥2 cm	13	73.9
Pulmonary metastasis			0.0151
Single	26	65.5
Multiple	2	0
Operative procedure			0.2088
Wedge resection	15	70.0
Segmentectomy	4	25.0
Lobectomy	9	66.7
Prethoracotomy CEA			0.0217
＜5 ng/mL	14	100
≥5 ng/mL	12	40.7
Uncheck	2	0
Disease free interval			0.929
＜24 mo	10	64.3
≥24 mo	18	54.6

CEA: carcinoembryonic antigen.

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