Lung metastases from colorectal cancer: Analysis of prognostic factors in a single institution study

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Abstract

Background. The aim of our study was to evaluateretrospectively in a large single institution setting allcases of lung resections for colorectal metastases from1998 to 2008 and to assess clinicopathologic factorsinfluencing outcome.

Methods. In all, 199 patients, 125 men and 74 women,with lung metastases of colorectal cancer, 120 colon and 79rectum, underwent resection with curative intent; meaninterval between primary surgery and lung metastasis was35 months. Carcinoembryonic antigen preoperative valuewas abnormal in 52 patients; K-RAS wild-type wasdetected in 60 of 97 examined cases; 75 patients receivedpreoperative or postoperative chemotherapy or both. Asolitary lesion was described in 95 patients (47.7%), two orthree metastases in 72 (36.2%), and more than three metastasesin 26 (13.1%). Nodal status was reported in 130patients (73%). One hundred twenty patients (60.3%) underwentwedge resection, 27 (13.6%) underwent segmentectomy,and 52 (26.1%) had lobectomy. An R0 resectionwas achieved in 178 cases (89.4%).

Results. Median overall survival was 4.2 years (95%confidence interval: 3.1 to 5.1) with a 5-year overallsurvival of 43% (95% confidence interval: 36% to 50%).An R1 resection (log rank p [ 0.0001), thoracic nodalinvolvement (log rank p [ 0.0002), and preoperativeabnormal carcinoembryonic antigen value (log rankp <0.001) were significantly associated with pooroutcome in univariate analysis. In multivariate analysis,the same variables plus the number of lesions(single versus multiple, p [ 0.04) were shown to affectoutcome.

Conclusions. An R0 resection, preoperative carcinoembryonicantigen, nodal involvement, and number oflesions represent strong prognostic factors in patient withlung metastases of colorectal cancer. The role of systemictreatments and biomolecular tests deserve future prospectiveinvestigations.

Original languageEnglish
Pages (from-to)1238-1245
Number of pages8
JournalAnnals of Thoracic Surgery
Volume98
Issue number4
DOIs
Publication statusPublished - Oct 1 2014

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Colorectal Neoplasms
Neoplasm Metastasis
Lung
Carcinoembryonic Antigen
Confidence Intervals
Segmental Mastectomy
Colonic Neoplasms
Thorax
Multivariate Analysis
Drug Therapy
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

@article{e7b1e5cd2e8c497bb69bdee13693dbb7,
title = "Lung metastases from colorectal cancer: Analysis of prognostic factors in a single institution study",
abstract = "Background. The aim of our study was to evaluateretrospectively in a large single institution setting allcases of lung resections for colorectal metastases from1998 to 2008 and to assess clinicopathologic factorsinfluencing outcome.Methods. In all, 199 patients, 125 men and 74 women,with lung metastases of colorectal cancer, 120 colon and 79rectum, underwent resection with curative intent; meaninterval between primary surgery and lung metastasis was35 months. Carcinoembryonic antigen preoperative valuewas abnormal in 52 patients; K-RAS wild-type wasdetected in 60 of 97 examined cases; 75 patients receivedpreoperative or postoperative chemotherapy or both. Asolitary lesion was described in 95 patients (47.7{\%}), two orthree metastases in 72 (36.2{\%}), and more than three metastasesin 26 (13.1{\%}). Nodal status was reported in 130patients (73{\%}). One hundred twenty patients (60.3{\%}) underwentwedge resection, 27 (13.6{\%}) underwent segmentectomy,and 52 (26.1{\%}) had lobectomy. An R0 resectionwas achieved in 178 cases (89.4{\%}).Results. Median overall survival was 4.2 years (95{\%}confidence interval: 3.1 to 5.1) with a 5-year overallsurvival of 43{\%} (95{\%} confidence interval: 36{\%} to 50{\%}).An R1 resection (log rank p [ 0.0001), thoracic nodalinvolvement (log rank p [ 0.0002), and preoperativeabnormal carcinoembryonic antigen value (log rankp <0.001) were significantly associated with pooroutcome in univariate analysis. In multivariate analysis,the same variables plus the number of lesions(single versus multiple, p [ 0.04) were shown to affectoutcome.Conclusions. An R0 resection, preoperative carcinoembryonicantigen, nodal involvement, and number oflesions represent strong prognostic factors in patient withlung metastases of colorectal cancer. The role of systemictreatments and biomolecular tests deserve future prospectiveinvestigations.",
author = "Zampino, {Maria Giulia} and Patrick Maisonneuve and Ravenda, {Paola Simona} and Elena Magni and Monica Casiraghi and Piergiorgio Solli and Francesco Petrella and Roberto Gasparri and Domenico Galetta and Alessandro Borri and Stefano Donghi and Giulia Veronesi and Lorenzo Spaggiari",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.athoracsur.2014.05.048",
language = "English",
volume = "98",
pages = "1238--1245",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "The Society of Thoracic Surgeons. Published by Elsevier Inc",
number = "4",

}

TY - JOUR

T1 - Lung metastases from colorectal cancer

T2 - Analysis of prognostic factors in a single institution study

AU - Zampino, Maria Giulia

AU - Maisonneuve, Patrick

AU - Ravenda, Paola Simona

AU - Magni, Elena

AU - Casiraghi, Monica

AU - Solli, Piergiorgio

AU - Petrella, Francesco

AU - Gasparri, Roberto

AU - Galetta, Domenico

AU - Borri, Alessandro

AU - Donghi, Stefano

AU - Veronesi, Giulia

AU - Spaggiari, Lorenzo

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background. The aim of our study was to evaluateretrospectively in a large single institution setting allcases of lung resections for colorectal metastases from1998 to 2008 and to assess clinicopathologic factorsinfluencing outcome.Methods. In all, 199 patients, 125 men and 74 women,with lung metastases of colorectal cancer, 120 colon and 79rectum, underwent resection with curative intent; meaninterval between primary surgery and lung metastasis was35 months. Carcinoembryonic antigen preoperative valuewas abnormal in 52 patients; K-RAS wild-type wasdetected in 60 of 97 examined cases; 75 patients receivedpreoperative or postoperative chemotherapy or both. Asolitary lesion was described in 95 patients (47.7%), two orthree metastases in 72 (36.2%), and more than three metastasesin 26 (13.1%). Nodal status was reported in 130patients (73%). One hundred twenty patients (60.3%) underwentwedge resection, 27 (13.6%) underwent segmentectomy,and 52 (26.1%) had lobectomy. An R0 resectionwas achieved in 178 cases (89.4%).Results. Median overall survival was 4.2 years (95%confidence interval: 3.1 to 5.1) with a 5-year overallsurvival of 43% (95% confidence interval: 36% to 50%).An R1 resection (log rank p [ 0.0001), thoracic nodalinvolvement (log rank p [ 0.0002), and preoperativeabnormal carcinoembryonic antigen value (log rankp <0.001) were significantly associated with pooroutcome in univariate analysis. In multivariate analysis,the same variables plus the number of lesions(single versus multiple, p [ 0.04) were shown to affectoutcome.Conclusions. An R0 resection, preoperative carcinoembryonicantigen, nodal involvement, and number oflesions represent strong prognostic factors in patient withlung metastases of colorectal cancer. The role of systemictreatments and biomolecular tests deserve future prospectiveinvestigations.

AB - Background. The aim of our study was to evaluateretrospectively in a large single institution setting allcases of lung resections for colorectal metastases from1998 to 2008 and to assess clinicopathologic factorsinfluencing outcome.Methods. In all, 199 patients, 125 men and 74 women,with lung metastases of colorectal cancer, 120 colon and 79rectum, underwent resection with curative intent; meaninterval between primary surgery and lung metastasis was35 months. Carcinoembryonic antigen preoperative valuewas abnormal in 52 patients; K-RAS wild-type wasdetected in 60 of 97 examined cases; 75 patients receivedpreoperative or postoperative chemotherapy or both. Asolitary lesion was described in 95 patients (47.7%), two orthree metastases in 72 (36.2%), and more than three metastasesin 26 (13.1%). Nodal status was reported in 130patients (73%). One hundred twenty patients (60.3%) underwentwedge resection, 27 (13.6%) underwent segmentectomy,and 52 (26.1%) had lobectomy. An R0 resectionwas achieved in 178 cases (89.4%).Results. Median overall survival was 4.2 years (95%confidence interval: 3.1 to 5.1) with a 5-year overallsurvival of 43% (95% confidence interval: 36% to 50%).An R1 resection (log rank p [ 0.0001), thoracic nodalinvolvement (log rank p [ 0.0002), and preoperativeabnormal carcinoembryonic antigen value (log rankp <0.001) were significantly associated with pooroutcome in univariate analysis. In multivariate analysis,the same variables plus the number of lesions(single versus multiple, p [ 0.04) were shown to affectoutcome.Conclusions. An R0 resection, preoperative carcinoembryonicantigen, nodal involvement, and number oflesions represent strong prognostic factors in patient withlung metastases of colorectal cancer. The role of systemictreatments and biomolecular tests deserve future prospectiveinvestigations.

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JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

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