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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 104 - 115 (12page)
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Purpose Prognostic factors in patients with pulmonary metastases (PM) from colorectal cancer (CRC) are still controversial. This study assessed oncologic outcomes and prognostic factors in patients with metachronous PM from CRC.
Materials and Methods Between June 2003 and December 2011, 122 patients with CRC underwent curative resection of PM detected at least 4 months after CRC resection. Clinico-pathological factors selected from the prospectively maintained database were analyzed retrospectively.
Results The median disease-free interval (DFI) between resection of the primary tumor and detection of PM was 22.0 months (range, 4 to 85 months). Solitary PM were detected in 77 patients (63.1%), with a median maximal tumor diameter of 12.0 mm (range, 2 to 70 mm). Of 52 patients who underwent mediastinal lymph node (LN) dissection, eight patients had LN involvement. Five-year overall survival and disease-free survival (DFS) rates after initial pulmonary metastasectomy were 66.4% and 50.9%, respectively. DFI, mediastinal LN involvement, and the number and distribution of PM were significantly prognostic factors for DFS. In multivariable analysis DFI 12 months, solitary lesion, and absence of mediastinal LN involvement were independently prognostic for DFS. Of the 122 patients, 48 patients (39.3%) developed recurrent PM a median 13.0 months after initial pulmonary metastasectomy. Recurrent DFI was independently prognostic of DFS in patients who underwent repeated pulmonary metastasectomy.
Conclusion There is a potential survival benefit for patients with metachronous PM from CRC who undergo pulmonary metastasectomy, even those with recurrent PM. Pulmonary metastasectomy should be considered in selected patients, particularly those with longer DFI, solitary lesions, and absence of mediastinal LN involvement.
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참고문헌 (24)
참고문헌 신청
August DA / 1984 / Clinical perspective of human colorectal cancer metastasis / Cancer Metastasis Rev 3 : 303 ~ 324
Chen F / 2010 / Repeat resection of pulmonary metastasis is beneficial for patients with colorectal carcinoma / World J Surg 34 : 2373 ~ 2378
Cho S / 2013 / Prognostic factors of pulmonary metastasis from colorectal carcinoma / Interact Cardiovasc Thorac Surg 17 : 303 ~ 307
Gatta G / 1998 / Survival of colorectal cancer patients in Europe during the period 1978-1989. EUROCARE Working Group / Eur J Cancer 34 : 2176 ~ 2183
Girard P / 1996 / Surgery for lung metastases from colorectal cancer : analysis of prognostic factors / J Clin Oncol 14 : 2047 ~ 2053
Chen F / 2010 / Repeat resection of pulmonary metastasis is beneficial for patients with colorectal carcinoma / World J Surg 34 : 2373 ~ 2378
Cho S / 2013 / Prognostic factors of pulmonary metastasis from colorectal carcinoma / Interact Cardiovasc Thorac Surg 17 : 303 ~ 307
Gatta G / 1998 / Survival of colorectal cancer patients in Europe during the period 1978-1989. EUROCARE Working Group / Eur J Cancer 34 : 2176 ~ 2183
Girard P / 1996 / Surgery for lung metastases from colorectal cancer : analysis of prognostic factors / J Clin Oncol 14 : 2047 ~ 2053
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