title: Long-term survival after hepatic and pulmonary resection of colorectal cancer metastases.
abstract: BACKGROUND
  Recent changes in adjuvant therapies improved the prognosis of metastatic colorectal cancers. Curative resection may be considered, even for both pulmonary and hepatic metastases, but prognostic factors are not well identified.
  
  
  METHODS
  From 1995 to 2010, 69 patients had curative resection of pulmonary metastases of colorectal cancer; 31 had also hepatic metastases. Pulmonary and hepatic resection occurred in 2 steps (87%). We studied overall and disease-free survival and prognostic factors.
  
  
  RESULTS
  Primary tumor location was the rectum in 10 cases (32%). Pulmonary metastases were synchronous in 5 (16%) and bilateral in 6 (19%). One patient (3%) died after pulmonary surgery. One (3%) had positive surgical margins for pulmonary metastases. Median overall survival was 44 months (5-year rate = 36%); median disease-free survival was 22 months (5-year rate = 10%). Factors linked to impaired survival were rectal primary tumor (P = 0.04) and bilateral pulmonary metastases (P = 0.02) for overall survival, and pulmonary metastase ≥ 20 mm (P = 0.04) for disease-free survival.
  
  
  CONCLUSIONS
  When associated to adjuvant therapy, complete resection of pulmonary and hepatic metastases of colorectal cancer allows long-term survival in one third of the patients.
authors.affiliation: Department of Thoracic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique-Hôpitaux de Paris, Université Paris 7, Paris, Clichy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sourrouille
authors.forename: Pierre
authors.initials: P
authors.lastname: Mordant
authors.forename: Léon
authors.initials: L
authors.lastname: Maggiori
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.forename: Guy
authors.initials: G
authors.lastname: Lesèche
authors.forename: Yves
authors.initials: Y
authors.lastname: Panis
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Yves
authors.initials: Y
authors.lastname: Castier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies
keywords: colorectal cancer; liver metastasis; lung metastasis; overall survival