title: Multiple resections for hepatic and pulmonary metastases of colorectal carcinoma.
abstract: BACKGROUND
  Resections are effective for some patients with both hepatic and pulmonary metastases of colorectal cancer, but the best selection criteria for the resections and effective treatment for recurrence after the resections have not been determined.
  
  
  METHODS
  A retrospective analysis was performed for 30 consecutive patients who received aggressive multiple resections for both hepatic and pulmonary metastases of colorectal cancer. Recurrences after resections were surgically treated whenever resectable.
  
  
  RESULTS
  For the 30 patients, 45 hepatectomies and 40 pulmonary resections were performed and 17 patients received three or more resections. No mortality was observed. Overall survival after the first metastasectomy for the second organ (liver or lung) was 58% and nine 5-year survivors were observed. Multivariate analyses revealed that primary colon cancer, stage IV in TNM classification and maximum size of hepatic tumor >3 cm at initial hepatectomy were poor prognostic factors, but several long-term survivors were observed even among patients with those factors.
  
  
  CONCLUSIONS
  Multiple resections for hepatic and pulmonary metastases of colorectal cancer are safe and effective. No single factor is considered to be a contraindication for the resections. For recurrence after the resections, surgical resection is also recommended if resectable.
authors.affiliation: Department of Hepato-biliary National Cancer Center Hospital East, Kashiwa, Chiba, Japan. shtakaha@east.ncc.go.jp
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kanji
authors.initials: K
authors.lastname: Nagai
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Nishimura
authors.forename: Junji
authors.initials: J
authors.lastname: Yoshida
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate