Prognostic factors in pulmonary metastases resection from colorectal cancer: impact of right-sided colon cancer and early recurrence

Yo Tsukamoto ¹, Takeo Nakada ², Rintaro Shigemori ³

⁰Department of Surgery, The Jikei University Hospital, Nishishinbashi 3-19-18, Minatoku, Tokyo, 105-8471, Japan. young1017@triton.ocn.ne.jp.

General Thoracic and Cardiovascular Surgery +

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April 26, 2024

View abstract on PubMed

Summary

Right-sided colon cancer and early recurrence after pulmonary metastases resection are poor prognostic factors for overall survival in colorectal cancer patients. Elevated CEA levels before surgery predict early recurrence.

Area Of Science

Oncology
Surgical Oncology
Gastroenterology

Background

Colorectal cancer (CRC) frequently metastasizes to the lungs, necessitating evaluation of surgical resection outcomes.
Pulmonary metastases (PM) resection is a key treatment modality for select CRC patients.

Purpose Of The Study

To investigate surgical outcomes, specifically overall survival (OS) and early recurrence, following pulmonary metastases resection in CRC patients.
To identify prognostic factors associated with OS and early recurrence after PM resection.

Main Methods

Retrospective cohort study of 60 patients undergoing PM resection for CRC between 2015-2021.
Analysis of overall survival (OS) and early recurrence (within one year) as primary outcomes.
Investigation of the association between right-sided colon cancer (RCC) and OS.

Main Results

Five-year OS was 83.8% after CRC resection and 69.4% after PM resection.
Right-sided colon cancer (RCC) and early recurrence were significant risk factors for poor OS (p<0.05).
Elevated carcinoembryonic antigen (CEA) levels (>5.0 mg/dL) prior to PM resection independently predicted early recurrence (p=0.034).

Conclusions

RCC and early recurrence are adverse prognostic indicators for OS in patients with PM from CRC.
Pre-operative CEA levels serve as a crucial predictor for early recurrence post-PM resection.
Further comparative studies on surgical versus non-surgical management for patients with elevated CEA are warranted.

Keywords:

Carcinoembryonic antigen Colorectal Liver metastases Pulmonary metastases Right-sided colorectal cancer Risk factors