title: Combined resection of colorectal hepatic-pulmonary metastases shows improved outcome over chemotherapy alone.
abstract: BACKGROUND
  The objective of this retrospective study was to assess the survival of patients after resection of hepatic and pulmonary colorectal metastases to identify predictors of long-term survival.
  
  
  METHODS
  Patients receiving chemotherapy alone were compared to patients receiving surgery and chemotherapy in a matched-pair analysis with the following criteria: UICC stage, grading, and date of initial primary tumor occurrence.
  
  
  RESULTS
  A total of 30 patients with liver and lung metastases of colorectal carcinoma underwent resection. In 20 cases, complete resection was achieved (median survival, 67 months). Incomplete resection and preoperatively elevated carcinoembryonic antigen (CEA) levels are independent risk factors for reduced survival. Patients developing pulmonary metastases prior to hepatic metastases had the worst prognosis. Surgical resection significantly increased survival compared to chemotherapy alone in matched-pair analysis (65 vs. 30 months, p = 0.03).
  
  
  CONCLUSIONS
  Incomplete resection and elevated CEA levels are predictors of poor outcome. Matched-paired analysis confirmed that surgical resection in combination with chemotherapy appears to be superior to chemotherapy alone.
authors: Department of General Thoracic Surgery, University of Munich-Grosshadern, Marchioninistrasse 15, Munich, Germany.
authors: Georgios
authors: G
authors: Meimarakis
authors: Martin
authors: M
authors: Angele
authors: Claudius
authors: C
authors: Conrad
authors: Rolf
authors: R
authors: Schauer
authors: Rolf
authors: R
authors: Weidenhagen
authors: Alexander
authors: A
authors: Crispin
authors: Clemens
authors: C
authors: Giessen
authors: Gerhard
authors: G
authors: Preissler
authors: Max
authors: M
authors: Wiedemann
authors: Karl-Walter
authors: KW
authors: Jauch
authors: Volker
authors: V
authors: Heinemann
authors: Sebastian
authors: S
authors: Stintzing
authors: Rudolf A
authors: RA
authors: Hatz
authors: Hauke
authors: H
authors: Winter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome