title: Surgical treatment of colorectal cancer pulmonary metastases: 12-year results.
abstract: The objective of the present study was to retrospectively analyze a cohort of patients who underwent surgery for colorectal cancer pulmonary metastases during a 12-year period.
  
  
  METHODS
  The sample included 75 patients who were monitored in terms of overall survival (OS) and disease-free interval (DFI) in relation to patient's age, preoperative values of biomarkers, type of surgery, number and size of metastases, occurrence of complications and length of hospitalisation.
  
  
  RESULTS
  A total of 95 surgical interventions were performed and 133 metastases were removed. Out of these, 28% of patients were free of any signs of relapse or disease progression for 5 years after metastasectomy. Those with two or more metastases are 2.3-times more at risk of disease progression. Tissue polypeptide specific antigen (TPS) values above the 140 IU/l cut-off point increase the risk of progression 3.9-times. The five-year survival rate among the group was 45%. Patients with 2 or more metastases are 2.7-times more at risk of death. TPS values above the 140 IU/l cut-off increase the risk of death 5.5 times, and carbohydrate antigen CA19-9 values above the 28 IU/ml cut-off point increase the risk of death by 3.2 times.
  
  
  CONCLUSIONS
  The number of metastases and the preoperative TPS values are decisive prognostic factors influencing both OS and DFI.
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic vodicka@fnplzen.cz.
authors: Josef
authors: J
authors: Vodicka
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Vladimir
authors: V
authors: Spidlen
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Vladislav
authors: V
authors: Treska
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Jakub
authors: J
authors: Fichtl
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Vaclav
authors: V
authors: Simanek
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Jarmil
authors: J
authors: Safranek
authors: Department of Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Sarka
authors: S
authors: Vejvodova
authors: Sikl's Pathology Institute, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Petr
authors: P
authors: Mukensnabl
authors: Department of Nuclear Medicine - Immunoanalytical Laboratory, Faculty of Medicine in Pilsen, Charles University in Prague, University Hospital in Pilsen, Pilsen, Czech Republic.
authors: Ondrej
authors: O
authors: Topolcan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D016016:Proportional Hazards Models
keywords: Colorectal cancer; TPS; lymphadenectomy; metastasectomy; pulmonary metastasis