Outcomes after repeated resection for recurrent pulmonary metastases from colorectal cancer.
BACKGROUND
It remains controversial whether metastasectomy is still feasible in patients with pulmonary recurrence from colorectal cancer, after initial metastasectomy. The aim of this study was to evaluate outcomes of repeated metastasectomy in these patients.


METHODS
From 1995 to 2007, 202 patients had received a pulmonary metastasectomy from colorectal cancer at our institution. Over a median follow-up of 28.9 months, 48 patients received second metastasectomy (29 wedge resections, 5 segmentectomies, 13 lobectomies, and 1 completion pneumonectomy). The median disease-free interval was 9.6 months. Among these 48 patients, 28 showed pulmonary recurrence again and of those, 10 patients received third metastasectomy (two wedge resections, two segmentectomies, four lobectomies, and two completion pneumonectomies).


RESULTS
There was no postoperative mortality. Of the 48 patients who underwent second metastasectomy, overall and disease-free 5-year survivals were 79% and 49%, respectively, after second operation. Of the 10 patients who received third metastasectomy, overall survival was 78% at 5 years after last operation.


CONCLUSIONS
Repeated resection after initial metastasectomy can be carried out safely and provides long-term survival in patients with recurrent pulmonary metastasis from colorectal cancer. Our findings indicate that close follow-up for the early detection of recurrence and parenchyma-saving resection can improve the results after repeated resection.
Park
J S
JS
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Kim
H K
HK
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Choi
Y S
YS
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Kim
K
K
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Shim
Y M
YM
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Jo
J
J
Cancer Research Center, Center for Clinical Research, Samsung Biomedical Research Institute.
Lee
W-Y
WY
Department of Surgery.
Chun
H-K
HK
Department of Surgery.
Park
Y S
YS
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kang
W K
WK
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kim
J
J
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine. Electronic address: jkimsmc@skku.edu.
D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D010507:Periodicity; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome