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[Lung metastases from colorectal cancer: results of surgery]
P Girard1, P Baldeyrou, D Grunenwald
1Service de Chirurgie thoracique, Institut mutualiste Montsouris, Centre médico-chirurgical de la Porte de Choisy, Paris.
Objectives:
Surgery has become a recognized therapeutic means in selected patients with isolated pulmonary metastases, with a 5-year survival rate of about 35%, but specific studies on the results and prognosis of surgery for pulmonary metastases from colorectal cancer remain relatively rare.
Methods:
Between 1980 and 1991, 65 patients (34 men, 31 women, mean age 58.2 years) underwent 81 thoracic operations with curative intent (including 15 bilateral operations and 7 incomplete resections) for pulmonary metastases from colorectal cancer.
Results:
The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 27% and 22% respectively. The site of the primary tumor (colon or rectum), the disease-free interval, previous resection(s) of hepatic metastases, and the size of pulmonary metastases were not found to the have a statistically significant influence on prognosis. On the other hand, the quality of resection (complete or incomplete) (p < 0.001), the number of resected pulmonary metastases (p = 0.016), and the preoperative carcino-embryonic antigen level (p < 0.001) were found to be highly significant prognostic factors.
Conclusion:
Complete resection of pulmonary metastases from colorectal cancer seems to prolong survival in a significant number of patients, and the results from this study should help to select those who may benefit from this treatment.