Staged pulmonary and hepatic metastasectomy in colorectal cancer--is it worth it?
OBJECTIVE
Resection of isolated pulmonary and hepatic metastases from colorectal cancer can offer potential cure. However, little data is available to determine the results of staged hepatic and pulmonary resections in the same patient.


METHODS
We retrospectively reviewed all patients who underwent staged hepatic and pulmonary metastasectomy for colorectal cancer in our institute from September 1998 to May 2002. Probability of survival was estimated by the Kaplan-Meier method.


RESULTS
Thirty-three metastasectomies (seven redo) were carried out in 26 patients. There were 19 male and 7 female patients with a mean age of 61 years (range 34-76 years). The mean disease-free interval for hepatic and pulmonary resection was 21.8 and 23.9 months, respectively. Sternotomy, thoracotomy and video assisted thoracoscopic approach were used in 3.03, 72.7 and 24.2% of patients, respectively. Wedge excision, lobectomy and pneumonectomy were carried out in 87.87, 9.09 and 3.03% of cases, respectively. There was one hospital death following acute respiratory failure after pneumonectomy. Mean follow-up was 23.3 months (range 2-71 months). The mean survival after last pulmonary resection was 34.7 months (SE 3.03 and 95% CI of 28.8-40.6).


CONCLUSIONS
Our results support aggressive surgical management of pulmonary and hepatic metastases in colorectal cancer.
Reddy
Rajashekara H V
RH
Department of Thoracic Surgery, Leeds General Infirmary, D Floor, Jubilee Building, Great George Street, LS1 3EX, Leeds, UK.
Kumar
Bhaskar
B
Shah
Rajesh
R
Mirsadraee
Saeed
S
Papagiannopoulos
Kostas
K
Lodge
Peter
P
Thorpe
James A C
JA
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome