title: Lung metastasectomy for colorectal carcinoma in patients with a history of hepatic metastasis.
abstract: BACKGROUND
  We reviewed resection of pulmonary metastases preformed by the Department of Thoracic Surgery at Kyoto University Hospital to confirm the clinical significance of this surgery in patients with colorectal carcinoma and a history of hepatic metastasis.
  
  
  METHODS
  From 1992 to 2006, 19 patients with colorectal carcinoma and a history of hepatic metastasis underwent a pulmonary metastasectomy. Surgical outcomes of these patients were investigated in terms of various perioperative variables.
  
  
  RESULTS
  Sixteen of 19 patients showed metachronous presentation of hepatic and pulmonary metastases, while 3 patients showed synchronous presentation. Overall survival rate after the pulmonary resection was 93%, at 1 year; 75%, at 3 years and 60% at 5 years. Three years after the pulmonary resection, none of the patients with synchronous hepatic and pulmonary metastases survived, while patients with metachronous metastases had an overall survival rate of more than 80%. Interestingly enough, the overall survival curve of the patients with colorectal carcinoma and a history of hepatic metastasis, who underwent a pulmonary metastasectomy was almost the same as that of patients who did not have the surgery, during the same period.
  
  
  CONCLUSIONS
  Aggressive resection of pulmonary metastases in a select group of colorectal cancer patients with a history of liver metastases might result in prolonged survival.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, Japan.
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shoji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakai
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyahara
authors.forename: Toru
authors.initials: T
authors.lastname: Bando
authors.forename: Kenichi
authors.initials: K
authors.lastname: Okubo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome