title: More than one pulmonary resections or combined lung-liver resection in 79 patients with metastatic colorectal carcinoma.
abstract: BACKGROUND
  The way to select patients who will benefit from surgical resection of pulmonary metastases of colorectal carcinoma (CRC) remains unclear.
  
  
  METHODS
  We analyze overall survival and potential prognostic factors in 101 pulmonary resections of CRC metastases in 79 patients, focusing on cases with repeated pulmonary resection or with hepatic metastasectomy.
  
  
  RESULTS
  Number of pathological pulmonary metastases was higher than that of preoperatively suspected pulmonary nodules in 18% of the resections. Morbidity rate was 16.5%. There was no mortality. Five-year survival rates from the resection of the CRC and from the first pulmonary metastasectomy were 74.6% and 53.3%, respectively. Prognosis did not decrease in patients with history of hepatic metastasectomy or in those in which repeated pulmonary resection was performed. Age ≥70, preoperative carcinoembrionary antigen (CEA) ≥5 ng/dl and mediastinal lymph node involvement entailed worse prognosis. Pathological lymph node involvement and age were shown as independent prognostic factors in the multivariate analysis.
  
  
  CONCLUSIONS
  Resection of pulmonary metastases of CRC is a safe procedure, with 5-year survival rates over 50%. History of resected hepatic metastases or needs for more than one pulmonary resection do not seem to decrease survival rates. Only lymph node involvement and age seem to be clearly associated to worse prognosis.
authors.affiliation: Thoracic Surgery Department, Hospital Clínico San Carlos, Madrid, Spain. jrjarabo@terra.es
authors.forename: Jose R
authors.initials: JR
authors.lastname: Jarabo
authors.forename: Elena
authors.initials: E
authors.lastname: Fernández
authors.forename: Joaquín
authors.initials: J
authors.lastname: Calatayud
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gómez
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Torres
authors.forename: Florentino
authors.initials: F
authors.lastname: Hernando
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome