title: Early intrapulmonary recurrence after pulmonary metastasectomy related to colorectal cancer.
abstract: BACKGROUND
  Early intrapulmonary recurrence is a major problem after pulmonary metastasectomy related to colorectal cancer. However, the risk factors for early intrapulmonary recurrence are not clear.
  
  
  METHODS
  Between August 2001 and December 2007, 125 patients underwent pulmonary metastasectomy after colorectal cancer. The prognostic factors for overall survival were evaluated, including early (within 6 months) intrapulmonary recurrence. The factors related to early intrapulmonary recurrence were also analyzed.
  
  
  RESULTS
  Thirteen patients (10.4%) had early intrapulmonary recurrence. The median follow-up was 46 months (range, 21 to 99). Early intrapulmonary recurrence (hazard ratio 2.716; 95% confidence interval: 1.027 to 7.182; p = 0.044), extrapulmonary metastasectomy, metastatic hilar or mediastinal lymph nodes, and high prethoracotomy carcinoembryonic antigen levels were independent prognostic factors on multivariate analysis. Extrapulmonary metastasectomy (odds ratio 4.840; 95% confidence interval: 1.314 to 17.821; p = 0.018) and bilateral pulmonary metastasis (odds ratio 6.228; 95% confidence interval: 1.689 to 22.960; p = 0.006) were independent risk factors for early intrapulmonary recurrence.
  
  
  CONCLUSIONS
  Early intrapulmonary recurrence after pulmonary metastasectomy related to colorectal cancer is a prognostic factor for poor overall survival. Extrapulmonary metastasectomy and bilateral pulmonary metastasis are risk factors for early intrapulmonary recurrence. Pulmonary metastasectomy in patients with these risk factors should be considered carefully.
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Mi Ri
authors.initials: MR
authors.lastname: Hwang
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Chang
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Hyo Seong
authors.initials: HS
authors.lastname: Choi
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Jae Ill
authors.initials: JI
authors.lastname: Zo
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011013:Pneumonectomy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors