title: Colorectal cancer pulmonary oligometastases: pooled analysis and construction of a clinical lung metastasectomy prognostic model.
abstract: BACKGROUND
  Although resecting colorectal cancer (CRC) pulmonary metastasis is associated with long-term survival, identification of prognostic groups is needed for future randomized trials, and construction of a lung metastasectomy prognostic model (LMPM) is warranted.
  
  
  METHODS
  We searched the PubMed database for retrospective studies evaluating prognostic factors following resecting CRC lung metastasis. Individual patient data were analyzed. Independent prognostic factors were used to construct an LMPM.
  
  
  RESULTS
  Between 1983 and 2008, 1112 metastasectomies were carried out on 927 patients included in eight studies. Five-year survival rate was 54.3% following the first lung resection. Multivariate analysis identified three independently poor prognostic factors: pre-thoracotomy carcinoembryonic antigen ≥5 ng/ml, disease-free interval <36 months, and more than one metastatic lesion. Patients with good-, intermediate-, and high-risk groups according to the LMPM had a 5-year survival of 68.2%, 46.4%, and 26.1%, respectively (P < 0.001). Perioperative chemotherapy and previously resected liver metastasis had no influence on survival.
  
  
  CONCLUSIONS
  The low- and intermediate-risk groups have a good chance of long-term survival following metastasectomy. However, more studies are needed to investigate whether surgery offers any advantage over systemic therapy for the poor-risk group.
authors.affiliation: Medical Oncology Department, King Hussein Cancer Center, Amman, Jordan. Electronic address: ssalah@khcc.jo.
authors.forename: S
authors.initials: S
authors.lastname: Salah
authors.affiliation: Department of Surgery, Tohoku University, Sendai; Department of Surgical Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, Essen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Welter
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Park
authors.affiliation: Center for Colorectal Cancer, National Cancer Center. Gyeonggi-do, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Park
authors.affiliation: Thoracic Surgery Service, Hospital Donostia, San Sebastian, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Zabaleta
authors.affiliation: Department of Clinical and Biological Sciences, Thoracic Surgery Unit, University of Turin, San Luigi Hospital, Orbassano (Torino) Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ardissone
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Thoracic Surgery, Georges Pompidou European Hospital, Paris-Descartes University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Riquet
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University, Yokohama City, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nojiri
authors.affiliation: Department of Clinical and Biological Sciences, Thoracic Surgery Unit, University of Turin, San Luigi Hospital, Orbassano (Torino) Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gisabella
authors.affiliation: Center for Colorectal Cancer, National Cancer Center. Gyeonggi-do, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University, Yokohama City, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Medical Oncology Department, King Hussein Cancer Center, Amman, Jordan.
authors.forename: B
authors.initials: B
authors.lastname: Al-Haj Ali
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008954:Models, Biological; D011379:Prognosis