title: [Surgical treatment of pulmonary metastases of colorectal cancer. Do the indications evolved?].
abstract: OBJECTIVE
  The aim of this study was to evaluate a single-institution experience in the surgical treatment of lung metastases from colorectal cancer.
  
  
  METHODS
  During a 16 years period, 42 patients underwent lung metastasectomy at the University Hospital of Nice for a total of 57 surgical interventions. Data were retrospectively collected and analysed in term of prognostic factors and long-term survival.
  
  
  RESULTS
  The mean age was 64.5 years and there were 26 males and 16 females. In 36 cases lung metastasis were metachronous and the disease-free mean interval was 28.7 months. Eighteen patients had bilateral disease. In ten patients hepatic metastasectomy was done before lung resection. Forty-seven operations were performed for the 1(st) episode of lung metastasis (1 bilobectomy, 21 lobectomy, 4 segmentectomy and 38 wedge resections). Mediastinal metastatic disease was present in six patients. No patient died and the postoperative morbidity was 6.25%. Six patients needed operation for recurrent disease. Two patients died after completion pneumonectomy. Overall five and ten-year survival were 29.5 respectively 26.2%. The log-rank test identified two significant prognostic factors: radicality of metastasectomy (P =0.0066) and a disease-free interval longer than two years (P= 0.0021).
  
  
  CONCLUSIONS
  Our study suggests that local control of lung metastasis can improve survival only when a radical resection can be achieved. Selection criteria need to be improved in order to avoid unnecessary lung resection in patients with high risk of recurrences. The Pet-scan should probably have a certain interest in selecting these patients.
authors.affiliation: Service de chirurgie thoracique, 30, avenue de la Voie-Romaine, 06000, Nice, France. danielpopch@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Pop
authors.forename: N
authors.initials: N
authors.lastname: Venissac
authors.forename: F
authors.initials: F
authors.lastname: Leo
authors.forename: B-S
authors.initials: BS
authors.lastname: Karimdjee
authors.forename: S
authors.initials: S
authors.lastname: Lopez
authors.forename: J
authors.initials: J
authors.lastname: Mouroux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012189:Retrospective Studies; D016019:Survival Analysis