Natural History of Patients with Subcentimeter Pulmonary Nodules Undergoing Hepatic Resection for Metastatic Colorectal Cancer
被引:55
作者:
Maithel, Shishir K.
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Emory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Maithel, Shishir K.
[1
]
Ginsberg, Michelle S.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Ginsberg, Michelle S.
[2
]
D'Amico, Francesco
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
D'Amico, Francesco
[3
]
DeMatteo, Ronald P.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
DeMatteo, Ronald P.
[3
]
Allen, Peter J.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Allen, Peter J.
[3
]
Fong, Yuman
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Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Fong, Yuman
[3
]
Blumgart, Leslie H.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Blumgart, Leslie H.
[3
]
Jarnagin, William R.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
Jarnagin, William R.
[3
]
D'Angelica, Michael I.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USAEmory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
D'Angelica, Michael I.
[3
]
机构:
[1] Emory Univ, Div Surg Oncol, Dept Surg, Atlanta, GA 30322 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY 10065 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Surg, Hepatopancreatobiliary Serv, New York, NY 10065 USA
BACKGROUND: CT imaging frequently detects subcentimeter pulmonary nodules (SPN) in patients undergoing resection of colorectal cancer liver metastases. Their clinical significance is unknown. STUDY DESIGN: Patients were identified who underwent hepatic resection for colorectal cancer liver metastases between October 2004 and March 2006. The presence and imaging features of preoperative SPN were analyzed for their association with progression-free survival (PFS), disease-specific survival (DSS), and SPN progression. RESULTS: One hundred sixty patients underwent liver resection and 68 (43%) had SPN identified pre-operatively. Median number of nodules was 1 (75(th) percentile: <= 2 nodules) and median size of the largest was 3 mm (25(th) to 75(th) percentile: 2 to 5 mm). SPN were unilateral in 77%, calcified in 19%, solid in 92%, and smooth in contour in 95% of patients. At median follow-up of 31 months for survivors, SPN were proven to be metastatic disease in 35% of patients (24 of 68), either by radiographic increase in size or number (n = 12) or histologic confirmation after resection (n = 12). Median PFS for the 160 patients was 16 months and 3-year DSS was 78%. There was a trend toward shorter median PFS in patients with preoperative SPN compared with patients with no SPN (12 versus 20 months; p = 0.242). There was no difference in 3-year DSS (70% versus 83%; p = 0.46). SPN progression after hepatic resection did not substantially affect 3-year DSS. Calcified nodules were less likely to progress compared with noncalcified nodules (8% versus 42%; p = 0.03). CONCLUSION: SPN are common among patients undergoing resection of colorectal cancer liver metastases and approximately one-third of these will prove to be metastatic disease. Presence of limited preoperative SPN might be associated with shorter PFS after hepatectomy, but does not substantially impact 3-year DSS, and should not necessarily preclude resection of hepatic metastases. (J Am Coll Surg 2010;210:31-38. (C) 2010 by the American College of Surgeons)
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页码:31 / 38
页数:8
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[1]
Abdalla EK, 2004, ANN SURG, V239, P818, DOI 10.1097/01.sla.0000128305.90650.71
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Bennett, Joseph J.
Schmidt, Carl R.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Schmidt, Carl R.
Klimstra, David S.
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机构:
Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Klimstra, David S.
Grobmyer, Stephen R.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Grobmyer, Stephen R.
Ishill, Nicole M.
论文数: 0引用数: 0
h-index: 0
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Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Ishill, Nicole M.
Angelica, Michael D.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Angelica, Michael D.
DeMatteo, Ronald P.
论文数: 0引用数: 0
h-index: 0
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
DeMatteo, Ronald P.
Fong, Yuman
论文数: 0引用数: 0
h-index: 0
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Fong, Yuman
Blumgart, Leslie H.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Blumgart, Leslie H.
Jarnagin, William R.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
机构:
Univ Virginia Hlth Syst, Dept Surg, Div Thorac Cardiovasc Surg, Charlottesville, VA 22908 USAUniv Virginia Hlth Syst, Dept Surg, Div Thorac Cardiovasc Surg, Charlottesville, VA 22908 USA
机构:
City Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA
Kernstine, Kemp H.
Grannis, Frederic W., Jr.
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City Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA
Grannis, Frederic W., Jr.
Rotter, Arnold J.
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机构:
City Hope Natl Med Ctr, Div Radiol, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Bennett, Joseph J.
Schmidt, Carl R.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Schmidt, Carl R.
Klimstra, David S.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Klimstra, David S.
Grobmyer, Stephen R.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Grobmyer, Stephen R.
Ishill, Nicole M.
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h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Ishill, Nicole M.
Angelica, Michael D.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Angelica, Michael D.
DeMatteo, Ronald P.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
DeMatteo, Ronald P.
Fong, Yuman
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Fong, Yuman
Blumgart, Leslie H.
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Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
Blumgart, Leslie H.
Jarnagin, William R.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Surg, Div Hepatobiliary Surg, New York, NY 10065 USA
机构:
Univ Virginia Hlth Syst, Dept Surg, Div Thorac Cardiovasc Surg, Charlottesville, VA 22908 USAUniv Virginia Hlth Syst, Dept Surg, Div Thorac Cardiovasc Surg, Charlottesville, VA 22908 USA
机构:
City Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA
Kernstine, Kemp H.
Grannis, Frederic W., Jr.
论文数: 0引用数: 0
h-index: 0
机构:
City Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA
Grannis, Frederic W., Jr.
Rotter, Arnold J.
论文数: 0引用数: 0
h-index: 0
机构:
City Hope Natl Med Ctr, Div Radiol, Duarte, CA 91010 USACity Hope Natl Med Ctr, Dept Thorac Surg, 1500 East Duarte Rd,Warsaw MOB,Suite 2001G, Duarte, CA 91010 USA