title: Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer.
abstract: OBJECTIVE
  To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer.
  
  
  METHODS
  Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chemotherapy was evaluated. Patients' outcome and predictive factors for overall survival were also investigated by univariate and multivariate analysis.
  
  
  RESULTS
  A total of 70 patients were included in the study. After standardized first-line chemotherapy, only 4 patients (5.7%) were converted to resectable disease. The median overall survival time in all patients was 19 mo (95% CI: 12.6-25.4), with a 2-year overall survival rate of 38.8%. No survival difference was found among different first-line chemotherapeutic regimens. Prognostic analysis demonstrated that only the first response assessment for first-line treatment was the independent factor for predicting overall survival. The median survival time in partial response, stable disease and progressive disease patients were 27 mo, 16 mo and 8 mo (P = 0.00001).
  
  
  CONCLUSIONS
  Pulmonary metastasectomy can only be performed in a small part of unresectable lung metastases patients after chemotherapy. Patients' first response assessment is an important prognostic factor.
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Li
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Peng
authors.forename: Jia-Qing
authors.initials: JQ
authors.lastname: Xiang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: San-Jun
authors.initials: SJ
authors.lastname: Cai
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
mesh_terms: D015179:Colorectal Neoplasms / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome