Surgery for Pulmonary Metastases from Colorectal Cancer

Hideto Fujita, Kazuhisa Yabushita, Isaku Yoshioka, Masafumi Inokuchi, Keiko Iwata, Hideyuki Ajisaka, Seiichi Yamamoto, Masahide Kaji, Kiichi Maeda and Kohji Konishi

Department of Surgery, Toyama Prefectural Central Hospital

Background: This study aims to identify which patients would benefit by surgery for pulmonary metastases from colorectal carcinoma. Methods: We retrospectively analyzed 30 patients with pulmonary resection for metastatic colorectal cancer at our hospital. The median disease-free interval, which was defined as the term that between the surgery of the primary tumor and the diagnosis of pulmonary metastasis, was 24 months. Nine cases had underwent surgery for extra pulmonary diseases as follows; 8 hepatectomy,1brain metastectomy. Results: The 5-year survival was 34.5%. Age, gender, operative procedure, tumor size, histology, preoperative CEA, extra pulmonary disease, primary tumor site and stage were not found to be statistically significant prognostic factors in univariate analysis. The number and the site of pulmonary tumors and lymph node metastases were important prognostic factors by univariate analysis, but only the number was identified as an independent prognostic factor in multivariate analysis. The 5-year survival for the patients with a single metastasis was 59.3%, as compared with 0% for those with multiple metastases. The5-year survival was 49.1% for the patients without a lymph node metastasis, as compared with 20.8% for those with lymphnode metastases. Conculusions: The resection of pulmonary metastases from colorectal carcinoma benefit to small group of patients, even with extra pulmonary metastases. The number of metastases was a significant prognostic factor.

Key words
pulmonary metastases, colorectal cancer, prognosis

Reprint requests
Hideto Fujita Department of surgery, Toyama Prefectural Central Hospital 2-2-78, Nishinagae, Toyama, 930-8550 JAPAN

Accepted
October 31, 2001

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