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Pulmonary resection for metastases of colorectal origin
H K van Halteren1, A N van Geel, A A Hart
1Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam.
Study Objective:
To develop selection criteria for pulmonary metastasectomy in patients with metastases of colorectal cancer confined to the lungs.
Design:
A retrospective study.
Setting:
Medical records of all patients operated on for this condition in the Netherlands in the period 1982 to 1992 (n = 38).
Intervention:
Evaluation by means of Cox's proportional hazards regression analysis of factors, which might relate to postthoracotomy disease-free survival and/or postthoracotomy survival.
Measurements And Results:
The 5-year disease-free survival was 31%, and the overall 5-year survival was 43% (Kaplan-Meyer). Multivariately, a number of three or fewer metastases (p = 0.012) and a short delay between detection of pulmonary metastases and resection (p = 0.05) related to a longer postthoracotomy disease-free interval. A longer interval between resection of the primary tumor and detection of lung metastases related to a longer postthoracotomy survival (p = 0.021).
Conclusions:
Patients with three or less pulmonary metastases of colorectal origin may benefit from resection; once metastases have been detected, resection should not be postponed.