Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study

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• 作者：Tomoyuki Hishida ; MD^a ; ^{thishida@nifty.com} ; Masahiro Tsuboi ; MD^a ; Takehiro Okumura ; MD^b ; Narikazu Boku ; MD^c ; Yasuhisa Ohde ; MD^d ; Yukinori Sakao ; MD^e ; Katsuo Yoshiya ; MD^f ; Ichinosuke Hyodo ; MD^g ; Keita Mori ; MS^h ; Haruhiko Kondo ; MDⁱ
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：103
• 期：2
• 页码：399-405
• 全文大小：301 K
• 卷排序：103

文摘

The purpose of this study was to clarify the long-term survival outcomes after repeated lung resection (RLR) of pulmonary metastases from colorectal cancer (PM-CRC) using data from a Japanese nationwide investigation.MethodsAmong 898 patients who underwent R0 resection of PM-CRC at 46 Japanese institutions between 2004 and 2008, we analyzed the data of 216 patients who experienced recurrence limited to the lung after initial resection of PM-CRC. Overall survival (OS) after RLR was analyzed, and prognostic factors were explored using a multivariate Cox analysis.ResultsOf a total 216 patients, 132 (61%) received RLR, and their 5-year OS rate was 75.3%. Twenty-two patients underwent a second RLR, and 2 patients underwent a third RLR; a favorable survival outcome was observed even after a second RLR (5-year OS rate, 55.1%). The prognostic factors associated with worse survival after RLR were concomitant liver metastasis, which had been completely resected or ablated at the initial lung metastasectomy (hazard ratio [HR], 4.84; 95% confidence interval [CI], 1.48–14.8) and location of the primary tumor in the rectum (HR, 3.16; 95% CI, 1.17–9.35). Patients without these 2 poor prognostic factors (n = 58) showed a 5-year OS rate of 82.6% after RLR.ConclusionsThis nationwide database study showed that RLR for resectable lung-limited recurrence after PM-CRC resection could provide favorable survival, especially for patients with colon cancer without liver metastases at the initial PM-CRC resection.