title: [Liver and lung metastases of colorectal cancer. Long-term survival and prognostic factors].
abstract: BACKGROUND
  The resection of liver and lung metastases from colorectal cancer has not yet been completely investigated. The aim of this study was to investigate the overall survival and prognostic factors for patients with liver and lung metastases from colorectal cancer.
  
  
  METHODS
  A retrospective review of a prospective database of 52 patients with liver and lung metastases from colorectal cancer, undergoing metastasectomy with curative intent from 1999-2009 at a single institution was carried out.
  
  
  RESULTS
  The mean overall survival (OS) was 64 months. For synchronous liver and lung metastases the mean overall survival was 63 months (5-year survival 54 %) and for metachronous liver and lung metastases 74 months (5-year survival 58 %, p = 0.451). A poor prognostic outcome was observed in cases of localization of the primary tumor in the rectum (OS 81 vs. 38 months, p = 0.004), with multiple lung metastases (≥ 2 metastases, OS 74 vs. 59 months, p = 0.032) and with disease progression after premetastasectomy chemotherapy (OS 74 vs. 63 vs. 15 months, p < 0.001). No influence on overall survival was detected for bilateral lung metastases, thoracic lymph node metastases, disease recurrence and disease-free interval < 36 months.
  
  
  CONCLUSIONS
  Metastasectomy for liver and lung metastases of colorectal cancer is associated with a good overall survival in selected cases. Patients with liver and lung metastases should not be routinely excluded from metastasectomy and patients with thoracic lymph node metastases should also not be routinely excluded. Negative prognostic factors for survival are localization of the tumor in the rectum, multiple metastases and disease progression after premetastasectomy chemotherapy. Patients with disease progression after premetastasectomy chemotherapy should be excluded from metastasectomy.
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland. Stefan.sponholz@helios-kliniken.de.
authors.forename: S
authors.initials: S
authors.lastname: Sponholz
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Bölükbas
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schirren
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Oguzhan
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Kudelin
authors.affiliation: Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Helios Kliniken Gruppe, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Schirren
mesh_terms: D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D059146:Metastasectomy; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Colon cancer; Liver metastases; Long-term survival; Lung metastases; Rectal cancer