Resection of pulmonary metastasis in colo-rectal cancer, factors that influence in the survival

Resección de las metástasis pulmonares en cáncer colo-rectal. Factores que influyen en la sobrevida

The study aims to evaluate clinically relevant prog­nostic factors and to define a subgroup of patients who would most benefit from such surgery.

Patients and methods: 125 patients with pulmonary metastases from colorectal cancer underwent lung resection. Median follow-up was 32,4+-3,2 months. Patients who had no evidence of recurrent extrathoracic disease, no more than three metastases on either side, lobectomy as the maximal surgical procedure, and adequate cardiorespiratory function were eligible far surgery. Univariate and multivariate Cox regression and classification and regression tree subgroup analyses were performed p = 0.05.

Results: men 54,4% (1, 19 ! 1). Median age 53,04+-11,5 years. Overal median survival was 33 months, with 3 and 5 years survival rates of 47 and 27 percent respectively. Size of me­tastases) and extent of resection were identified as independent prognostic factors. The primary tumor stage was significant in univariate analysis. Subgroup analysis defined two statistically relevant prognostic groups: patients with maximum metastasis size of 3. 75 cm or less with a disease-free interval of more than 1 O months and patients with larger metastases and a shorter disease­free interval. Median survival and 5 year survival were 45 months and 39 percent in the former group, and 24 months and less than 11 percent in the latter.

Conclusion: subgroup analysis provided criteria far the selection of patients far resection of lung metastases from colorectal cancer and differentiated between those at high or low risk or early tumour progression; the Jater patients would benefit most from surgery.