title: Outcome of surgical resection for recurrent pulmonary metastasis from colorectal carcinoma.
abstract: BACKGROUND
  The outcomes after repeat pulmonary resection for colorectal cancer (CRC) and the factors associated with the prognosis of these patients remain uncharacterized.
  
  
  METHODS
  Data on 156 patients who underwent curative resection of pulmonary metastasis from CRC were reviewed. Repeat pulmonary resection was performed in 25 patients; the present study examined the outcomes and factors associated with prognosis after repeat pulmonary resection.
  
  
  RESULTS
  The 5-year survival rate after the first pulmonary resection was 56.2%. A multivariate analysis identified a histological type other than well-differentiated adenocarcinoma, a high prethoracotomy serum carcinoembryonic antigen (CEA) level, and the presence of hilar or mediastinal lymph node metastasis as poor prognostic factors for the first pulmonary resection. The 5-year survival rate after repeat pulmonary resection was 42.1%. Hilar or mediastinal lymph node metastasis at the time of the repeat resection was significantly associated with poor survival.
  
  
  CONCLUSIONS
  Repeat pulmonary resection for metastatic CRC provides satisfactory outcomes. Hilar or mediastinal lymph node involvement is consistently associated with a poor prognosis after the first and repeat pulmonary resections.
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Japan. rkanzaki@tj8.so-net.ne.jp
authors.forename: Ryu
authors.initials: R
authors.lastname: Kanzaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Oda
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Jun
authors.initials: J
authors.lastname: Maeda
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Shingai
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome