title: Video-Assisted Thoracoscopic Pulmonary Metastasectomy in Patients with Colorectal Cancer: A Recent 10-Year Single-Institution Experience.
abstract: The purpose of this study was to identify independent unfavorable prognostic factors for patients who underwent video-assisted thoracoscopic surgery for resection of pulmonary metastases from colorectal cancer (CRC).
  
  
  
  Between January 2004 and December 2013, 131 patients with pulmonary metastases from CRC underwent the aforementioned procedure for the first time at our institution. Kaplan-Meier survival curves and log-rank tests were used to analyze the survival rates. Multivariate analyses were performed using the Cox proportional hazards regression model.
  
  
  
  The 5-year disease-free survival (DFS) rate of these 131 patients was 34 %. Multivariate analyses showed two variables to be independent significant unfavorable prognostic factors for DFS: preoperative high serum carcinoembryonic antigen (CEA) level and a greater number of pulmonary metastases. According to subgroup analyses that combined these two risk factors, the 5-year DFS rates were 58, 25, and 12 % for patients with 0, 1, or 2 risk factors, respectively.
  
  
  
  In patients who underwent video-assisted thoracoscopic surgery for pulmonary metastases from CRC, we identified two independent unfavorable prognostic factors for DFS: a high CEA level before metastasectomy and a greater number of pulmonary metastases. These factors can be used to identify higher- and lower-risk subgroups, which may help with selecting patients who would benefit the most from video-assisted thoracoscopic pulmonary metastasectomy.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan. r-maeda@fujita-hu.ac.jp.
authors.forename: Ryo
authors.initials: R
authors.lastname: Maeda
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Suda
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Hachimaru
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tochii
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tochii
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98, Dengakugakubo, kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000379:methods*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D047368:Tumor Burden
chemical_list: D002272:Carcinoembryonic Antigen
references.citation: Eur J Cardiothorac Surg. 2000 Dec;18(6):671-6; discussion 676-7
references.pmid: 11113674
references.citation: J Thorac Cardiovasc Surg. 1997 Jan;113(1):37-49
references.pmid: 9011700
references.citation: Eur J Cardiothorac Surg. 2007 Feb;31(2):167-72
references.pmid: 17150367
references.citation: Ann Surg Treat Res. 2015 May;88(5):253-9
references.pmid: 25960988
references.citation: Ann Surg Oncol. 2009 Apr;16(4):1026-32
references.pmid: 19184237
references.citation: Cancer Res. 2005 Oct 1;65(19):8809-17
references.pmid: 16204051
references.citation: Thorac Cardiovasc Surg. 2012 Sep;60(6):398-404
references.pmid: 22228090
references.citation: Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):303-7
references.pmid: 23613338
references.citation: Eur J Cardiothorac Surg. 2002 May;21(5):906-12
references.pmid: 12062285
references.citation: Eur J Cardiothorac Surg. 2009 Sep;36(3):469-74
references.pmid: 19464921
references.citation: Ann Thorac Surg. 2015 Feb;99(2):435-40
references.pmid: 25499475
references.citation: Ann Thorac Surg. 2006 Jul;82(1):254-60
references.pmid: 16798225
references.citation: Colorectal Dis. 2010 Jul;12(7 Online):e68-75
references.pmid: 19843115
references.citation: Ann Thorac Surg. 2014 Oct;98(4):1238-45
references.pmid: 25106681
references.citation: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references.pmid: 21296855
references.citation: J Thorac Cardiovasc Surg. 2003 Sep;126(3):732-9
references.pmid: 14502146
references.citation: Jpn J Clin Oncol. 2006 Oct;36(10):643-8
references.pmid: 16931541