Role of pulmonary metastasectomy in colorectal cancer in the era of modern multidisciplinary therapy

Purpose To clarify the role of pulmonary metastasectomy in colorectal cancer in the era of modern multidisciplinary therapy. Methods The characteristics and outcomes of the patients who underwent pulmonary metastasectomy for colorectal cancer through 2002 (n = 26) and from 2003 (n = 68) were compared. Results The patients treated from 2003 had a smaller tumor size and more frequently had a history of extra-pulmonary relapses than did those treated through 2002. There was a significant improvement in the 5-year overall survival (42.0% vs. 73.1%, p=0.03) but not the 5-year relapse-free survival (41.4% vs. 37.5%, p=0.85) after pulmonary metastasectomy from 2003. The rate of patients who received local therapy with curative intent after the first pulmonary metastasectomy was significantly higher in patients treated from 2003 than in those treated through 2002 [4/13, (31%) vs. 25/39 (64%), p=0.04]. The survival after relapse after the first pulmonary metastasectomy was significantly longer in patients treated from 2003 than in those treated through 2002 (median survival time: 14 vs. 47 months). Conclusions Pulmonary metastasectomy for colorectal cancer remains an important treatment option in the sense that it can achieve a good relapse-free survival.