title: The role of lung metastasis resection in improving outcome of colorectal cancer patients: results from a large retrospective study.
abstract: BACKGROUND
  The role of surgery for lung metastases (LM) secondary to colorectal cancer (CRC) remains controversial. The bulk of evidence is derived from single surgical series, hampering any definitive conclusions. The aim of this study was to compare the outcomes of CRC patients with LM submitted to surgery with those who were not.
  
  
  METHODS
  Data from 409 patients with LM as the first evidence of advanced disease were extracted from a database of 1,411 patients. Patients were divided into three groups: G1, comprised of 155 patients with pulmonary and extrapulmonary metastases; G2, comprised of 104 patients with LM only and no surgery; G3, comprised of 50 patients with LM only and submitted to surgery.
  
  
  RESULTS
  No difference in response rates emerged between G1 and G2. Median progression-free survival (PFS) times were: 10.3 months, 10.5 months, and 26.2 months for G1, G2, and G3, respectively. No difference in PFS times was observed between G1 and G2, whereas there was a statistically significant difference between G2 and G3. Median overall survival times were 24.2 months, 31.5 months, and 72.4 months, respectively. Survival times were longer in resected patients: 17 survived >5 years and three survived >10 years. In patients with LM only and no surgery, four survived for 5 years and none survived >10 years.
  
  
  CONCLUSIONS
  Even though patients with resectable LM are more likely to be those with a better outcome, our study provides evidence suggesting an active role of surgery in improving survival outcomes in this patient subset.
authors.affiliation: Oncology Unit, Department of Clinical and Biological Sciences, University of Torino, San Luigi di Orbassano, Italy. marco.tampellini@unito.it
authors.forename: Marco
authors.initials: M
authors.lastname: Tampellini
authors.forename: Azzurra
authors.initials: A
authors.lastname: Ottone
authors.forename: Elisa
authors.initials: E
authors.lastname: Bellini
authors.forename: Irene
authors.initials: I
authors.lastname: Alabiso
authors.forename: Chiara
authors.initials: C
authors.lastname: Baratelli
authors.forename: Raffaella
authors.initials: R
authors.lastname: Bitossi
authors.forename: Maria P
authors.initials: MP
authors.lastname: Brizzi
authors.forename: Anna
authors.initials: A
authors.lastname: Ferrero
authors.forename: Elisa
authors.initials: E
authors.lastname: Sperti
authors.forename: Francesco
authors.initials: F
authors.lastname: Leone
authors.forename: Stefania
authors.initials: S
authors.lastname: Miraglia
authors.forename: Laura
authors.initials: L
authors.lastname: Forti
authors.forename: Erica
authors.initials: E
authors.lastname: Bertona
authors.forename: Francesco
authors.initials: F
authors.lastname: Ardissone
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.forename: Oscar
authors.initials: O
authors.lastname: Alabiso
authors.forename: Massimo
authors.initials: M
authors.lastname: Aglietta
authors.forename: Giorgio V
authors.initials: GV
authors.lastname: Scagliotti
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome