title: Failure in resection of multiple pulmonary metastases from colorectal cancer.
abstract: BACKGROUND
  To clarify whether or not multiple pulmonary metastases from colorectal cancer are contraindicated for a surgical resection, we retrospectively evaluated the influence of the number of pulmonary metastases on both the postthoracotomy survival and the pattern of the first failure.
  
  
  METHODS
  From 1981 to 1993, 36 patients underwent a complete resection for pulmonary metastases from colorectal cancer.
  
  
  RESULTS
  Of the various factors investigated including gender, primary site, disease-free interval, tumor size, the number of metastases, type of resection, and the history of hepatic metastases, only the number of pulmonary metastases was found to be significantly related to postthoracotomy survival. The rate of disease-free survival at 5 years was 62% for solitary metastasis (n = 17), 35% for two metastases (n = 8), and 0% for four or more metastases (n = 11). The pattern of failure also differed according to the number of pulmonary metastases. In particular, the incidence of local recurrence at the primary site increased with the number of pulmonary metastases (ie, 1 of 17 patients with a solitary metastasis, 3 of 8 with two metastases, and 6 of 11 with four or more metastases).
  
  
  CONCLUSIONS
  These results suggest that multiple metastases might indicate the presence of local recurrence at the primary site; therefore, in cases of multiple pulmonary metastases, the primary site should be thoroughly explored.
authors.affiliation: Department of Chest Surgery, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuyama
authors.forename: H
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: J
authors.initials: J
authors.lastname: Miyagi
authors.forename: S
authors.initials: S
authors.lastname: Kuninaka
authors.forename: H
authors.initials: H
authors.lastname: Asoh
authors.forename: Y
authors.initials: Y
authors.lastname: Ichinose
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy; D012189:Retrospective Studies; D016896:Treatment Outcome