title: Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases.
abstract: BACKGROUND
  Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC). Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy.
  
  
  METHODS
  Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities.
  
  
  RESULTS
  Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS) and those who underwent surgery alone (S) respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens.
  
  
  CONCLUSIONS
  Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable.
authors: Department of Medicine, Royal Marsden Hospital, Sutton, Surrey, UK SM2 5PT.
authors: Eliza A
authors: EA
authors: Hawkes
authors: George
authors: G
authors: Ladas
authors: David
authors: D
authors: Cunningham
authors: Andrew G
authors: AG
authors: Nicholson
authors: Katharina
authors: K
authors: Wassilew
authors: Yolanda
authors: Y
authors: Barbachano
authors: Gihan
authors: G
authors: Ratnayake
authors: Sheela
authors: S
authors: Rao
authors: Ian
authors: I
authors: Chau
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011013:Pneumonectomy; D016016:Proportional Hazards Models
chemical_list: D000970:Antineoplastic Agents