title: Short-term Survival of Patients with Lung Metastases from Colorectal and Non-colorectal Cancer Who Underwent Pulmonary Metastasectomy.
abstract: The lung is a common site of metastases, whose prevalence varies as a function of the primary tumor site, which is usually colorectal cancer (CRC), breast carcinoma, or genitourinary cancers, such as ovary, urinary bladder and renal cell carcinomas. The aim of the present study was to analyze whether the site of primitive tumor affects overall survival (OS) of patients with lung metastases (LMs) who underwent pulmonary metastasectomy. The data of 41 patients with surgically treated CRC (Group A=22 patients) and non-colorectal carcinomas (Group B=19 patients), who developed matachronous LMs and underwent pulmonary metastasectomy with curative intent, were analyzed. The origin of non-colorectal LMs was genitourinary cancer in nine and breast cancer in 10 patients. Overall, there were 22 men and 19 women, with a median age of 65 years (range=31-80); 18 patients had a solitary metastatic tumor, while 23 had two or more LMs. Twenty-nine patients underwent wedge resection, through thoracotomy or video-assisted thoracic surgery, while 12 underwent pulmonary lobectomy. Seventy-five LMs were resected with a 5-tear OS of 48.8%. No difference was found between elderly (≥65 year-old) and younger patients (p=0.26), and between those with solitary or multiple LMs (p=0.62) in terms of survival rate. The female patients had a worse OS (31.6% vs. 63.6%; odds ratio (OR)=3.79, 95% confidence interval (CI)=1.03-13.91, p=0.003) compared to males, independent of the origin of primary cancer. There was no difference in the cumulative survival rates (OR=1.65, 95%CI=0.48-5.69, p=0.42) between Groups and the log-rank test (p=0.75) was not significant. In conclusion, the main pathological characteristics of metastatic lesions and advanced age do not appear to be associated with a poor prognosis in patients with LMs, while the female gender is a negative prognostic factor. Thus, the primary tumor site should not be considered a major criterion in selecting patients for pulmonary metastasectomy.
authors.affiliation: Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, School of Medicine, Padua, Italy flumachi@unipd.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Lumachi
authors.affiliation: Pneumology, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mazza
authors.affiliation: Medical Oncology, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Conte
authors.affiliation: Pneumology, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lo Re
authors.affiliation: Department of Neurosciences, University of Padua, School of Medicine, Padua, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.affiliation: Surgery 1, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Giordano B
authors.initials: GB
authors.lastname: Chiara
authors.affiliation: Surgery 1, S. Maria degli Angeli Hospital, Pordenone, Italy.
authors.forename: Stefano M M
authors.initials: SM
authors.lastname: Basso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
keywords: Lung metastases; colorectal cancer; prognostic factors; pulmonary metastasectomy