title: Analysis of treatment that includes both hepatic and pulmonary resections for colorectal metastases.
abstract: OBJECTIVE
  Hepatic or pulmonary resections for colorectal metastases are regarded as standard treatment worldwide; however, the clinical significance of both hepatic and pulmonary resections for colorectal metastases remains undefined. We reviewed our clinical experience to evaluate the benefit of this treatment.
  
  
  METHODS
  Between 1986 and 2010, 186 patients underwent potentially curative hepatic and/or pulmonary resections for colorectal metastases. Of these patients, 25 underwent both treatments (Group C), 100 underwent hepatic resections alone (Group H), and 61 underwent pulmonary resections alone (Group L). Univariate and multivariate analyses of the clinical and pathological variables in Group C and comparative survival analyses between Group C and Groups H-L were performed.
  
  
  RESULTS
  In Group C, the median survival after primary tumor resection, initial metastasectomy, and last metastasectomy were 97, 60, and 35 months, respectively, and the 5-year overall survival rates were 63, 54, and 38%, respectively. Multivariate analyses after initial metastasectomy revealed rectal tumors, multiple hepatic tumors, and simultaneous metastases as poor prognostic factors. Comparative survival analyses revealed no significant difference in overall survival between Group C and Groups H-L.
  
  
  CONCLUSIONS
  Hepatic and pulmonary resections for colorectal metastases improve survival and may even offer the potential for cure in selected patients.
authors.affiliation: Departments of Colorectal Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan, tmatsui@tcc.pref.tochigi.lg.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsui
authors.forename: Tosuke
authors.initials: T
authors.lastname: Kitamura
authors.forename: Heita
authors.initials: H
authors.lastname: Ozawa
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Matsuguma
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kotake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors