Prognostic factors in resection of pulmonary metastasis from colorectal cancer
Prognostic factors in resection of pulmonary metastasis from colorectal cancer
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DOI：
10.1002/bjs.4331
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发表时间：
2003-11-01
影响因子：
9.6
通讯作者：
Saito, N
中科院分区：
文献类型：
--
作者：
Watanabe, I;Arai, T;Saito, N
背景：本回顾性研究的目的是评估原发性结直肠癌和肺转移瘤的特征，以确定结直肠癌肺转移瘤切除术后总生存的预后因素和进一步肺内复发的危险因素。方法：对 49 例接受结直肠癌肺转移瘤切除的患者进行回顾性分析。评估的因素包括年龄、性别、原发结直肠癌的病理结果（深度、淋巴管侵犯、静脉侵犯、淋巴结转移、分化、Dukes分期）和肺转移（最大肿瘤大小、肿瘤数量、切除的完整性）、血清癌胚抗原水平、既往肝转移肝切除术以及肺转移切除手术方式。还审查了总生存率和肺内复发情况。结果：肺转移瘤切除后的 3 年生存率为 78%，5 年生存率为 56%。孤立性肺转移与生存率显着相关（P = 0.049）。原发性结直肠癌的病理特征对生存没有影响。组织学不完全切除肺转移瘤与肺复发显着相关（P = 0.034）。结论：结直肠癌肺转移瘤完全切除后，尤其是孤立性肺转移瘤患者，可以获得长期生存。
Background: The aim of this retrospective study was to evaluate characteristics of primary colorectal cancer and pulmonary metastases in order to identify prognostic factors for overall survival and risk factors for further intrapulmonary recurrence after resection of pulmonary metastases from colorectal cancer.Methods: Forty-nine patients who underwent resection of pulmonary metastases from colorectal cancer were reviewed. The factors assessed were age, sex, pathological findings of the original colorectal cancer (depth, lymphatic invasion, venous invasion, lymph node metastasis, differentiation, Dukes' stage) and pulmonary metastasis (maximum turnout size, number of tumours, completeness of resection), serum carcinoembryonic antigen level, previous hepatectomy for liver metastases, and surgical procedure for resection of pulmonary metastasis. Overall survival and intrapulmonary recurrence were also reviewed.Results: Survival rates after resection of pulmonary metastases were 78 per cent at 3 years and 56 per cent at 5 years. Solitary pulmonary metastases were significantly correlated with survival (P = 0.049). The pathological features of the primary colorectal cancer had no impact on survival. Histologically incomplete resection of pulmonary metastasis significantly correlated with pulmonary re-recurrence (P = 0.034).Conclusion: Long-term survival can be expected after complete resection of pulmonary metastases arising from colorectal cancer, especially in patients with a solitary pulmonary metastasis.