Pulmonary metastasectomy in elderly colorectal cancer patients: a retrospective single center study

Colorectal cancer (CRC) is one of the most common malignancies worldwide and the lung is one of the most frequent sites for CRC metastasis. The geriatric population is increasing, but clinical decision making is often influenced by the effect of aging. For this reason, the elderly population does not often receive potentially curative cancer treatments as offered to younger ones. From January 2000 to March 2016, 21 elderly patients (older than 75 years) underwent pulmonary resections for colorectal cancer pulmonary metastases. A postoperative morbidity rate of 23.8 % and a 30-day mortality rate of 4.8 % were reported. A cumulative overall survival of 34.19 ± 23.51 months (95 % CI 23.71-50.28) and a disease-free interval of 24.62 ± 23.79 months (95 % CI 6.44-39.56) were observed. By considering only R0 surgically resected patients, the 1-, 3- and 5-year OS were 94.1, 59.5 and 21.2 % with a mean overall survival and disease-free interval of 51.10 ± 7.82 and 42.75 ± 9.35, respectively. Concerning risk factors, an important correlation between the number of pulmonary metastases, surgical radicality and overall survival was reported (p = 0.030 and p = 0.005, respectively). In summary, according to our series, pulmonary metastasectomy in selected elderly CRC oligometastatic patients seems to be safe and effective.