title: Repeated resection of colorectal cancer pulmonary oligometastases: pooled analysis and prognostic assessment.
abstract: BACKGROUND
  Repeated resection of colorectal cancer pulmonary metastasis is associated with long-term survival. Nevertheless, very limited data addressing the best candidates for repeated pulmonary resection is available.
  
  
  METHODS
  We searched the PubMed database for retrospective studies evaluating lung metastasectomy for metastatic colorectal cancer (CRC). We included studies with available data about repeated pulmonary metastasectomy. Potential prognostic factors were analyzed for possible impact on survival following the second metastasectomy through univariate and multivariate analysis.
  
  
  RESULTS
  Between 1983 and 2008, 944 lung metastasectomies were carried out on 759 patients. Of those, 148 patients had a second metastasectomy. The 5-year survival rate was 52 % for patients who had 1 metastasectomy and 57.9 % from the second metastasectomy for patients who had repeated resection. More than 2 metastatic pulmonary nodules and maximum diameter of largest pulmonary nodule ≥3 cm were the only independent factors associated with inferior survival following repeated pulmonary resection.
  
  
  CONCLUSIONS
  In selected patients with metastatic CRC, repeated pulmonary metastasectomy offers an excellent chance for long-term survival and is associated with a quite low operative mortality. Patients with more than 2 metastatic nodules and a maximum diameter of the largest metastatic lung nodule of ≥3 cm have a significantly inferior survival.
authors: Medical Oncology Department, King Hussein Cancer Center, Amman, Jordan. ssalah@khcc.jo
authors: Samer
authors: S
authors: Salah
authors: Kazuhiro
authors: K
authors: Watanabe
authors: Joon Suk
authors: JS
authors: Park
authors: Alaa
authors: A
authors: Addasi
authors: Ji Won
authors: JW
authors: Park
authors: Jon
authors: J
authors: Zabaleta
authors: Francesco
authors: F
authors: Ardissone
authors: Jhingook
authors: J
authors: Kim
authors: Marc
authors: M
authors: Riquet
authors: Kazunori
authors: K
authors: Nojiri
authors: Mara
authors: M
authors: Gisabella
authors: Sun Young
authors: SY
authors: Kim
authors: Kuniya
authors: K
authors: Tanaka
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden