Early Intrapulmonary Recurrence After Pulmonary Metastasectomy Related to Colorectal Cancer

被引:47
作者
Hwang, Mi Ri
Park, Ji Won
Kim, Dae Yong
Chang, Hee Jin
Kim, Sun Young
Choi, Hyo Seong
Kim, Moon Soo
Zo, Jae Ill
Hwan, Jae
机构
[1] Natl Canc Ctr, Res Inst & Hosp, Ctr Colorectal Canc, Goyang, South Korea
[2] Natl Canc Ctr, Res Inst & Hosp, Ctr Lung Canc, Goyang, South Korea
关键词
FACTORS INFLUENCING SURVIVAL; SURGICAL RESECTION; PROGNOSTIC-FACTORS; HEPATIC RESECTION; LUNG METASTASES; CARCINOMA; FLUOROURACIL; EXPERIENCES; LEUCOVORIN;
D O I
10.1016/j.athoracsur.2010.04.058
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Early intrapulmonary recurrence is a major problem after pulmonary metastasectomy related to colorectal cancer. However, the risk factors for early intrapulmonary recurrence are not clear. Methods. Between August 2001 and December 2007, 125 patients underwent pulmonary metastasectomy after colorectal cancer. The prognostic factors for overall survival were evaluated, including early (within 6 months) intrapulmonary recurrence. The factors related to early intrapulmonary recurrence were also analyzed. Results. Thirteen patients (10.4%) had early intrapulmonary recurrence. The median follow-up was 46 months (range, 21 to 99). Early intrapulmonary recurrence (hazard ratio 2.716; 95% confidence interval: 1.027 to 7.182; p = 0.044), extrapulmonary metastasectomy, metastatic hilar or mediastinal lymph nodes, and high prethoracotomy carcinoembryonic antigen levels were independent prognostic factors on multivariate analysis. Extrapulmonary metastasectomy (odds ratio 4.840; 95% confidence interval: 1.314 to 17.821; p = 0.018) and bilateral pulmonary metastasis (odds ratio 6.228; 95% confidence interval: 1.689 to 22.960; p = 0.006) were independent risk factors for early intrapulmonary recurrence. Conclusions. Early intrapulmonary recurrence after pulmonary metastasectomy related to colorectal cancer is a prognostic factor for poor overall survival. Extrapulmonary metastasectomy and bilateral pulmonary metastasis are risk factors for early intrapulmonary recurrence. Pulmonary metastasectomy in patients with these risk factors should be considered carefully. (Ann Thorac Surg 2010;90:398-405) (C) 2010 by The Society of Thoracic Surgeons
引用
收藏
页码:398 / 405
页数:9
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