Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer.
OBJECTIVE
Aggressive surgical resection for hepatic metastasis is validated, however, concomitant liver and lung metastasis in colorectal cancer patients is equivocal.


METHODS
Clinicopathologic data from January 2008 through December 2012 were retrospectively reviewed in 234 patients with colorectal cancer with concomitant liver and lung metastasis. Clinicopathologic factors and survival data were analyzed.


RESULTS
Of the 234 patients, 129 (55.1%) had synchronous concomitant liver and lung metastasis from colorectal cancer and 36 (15.4%) had metachronous metastasis. Surgical resection was performed in 33 patients (25.6%) with synchronous and 6 (16.7%) with metachronous metastasis. Surgical resection showed better overall survival in both groups (synchronous, p=0.001; metachronous, p=0.028). In the synchronous metastatic group, complete resection of both liver and lung metastatic lesions had better survival outcomes than incomplete resection of two metastatic lesions (p=0.037). The primary site of colorectal cancer and complete resection were significant prognostic factors (p=0.06 and p=0.003, respectively).


CONCLUSIONS
Surgical resection for hepatic and pulmonary metastasis in colorectal cancer can improve complete remission and survival rate in resectable cases. Colorectal cancer with concomitant liver and lung metastasis is not a poor prognostic factor or a contraindication for surgical treatments, hence, an aggressive surgical approach may be recommended in well-selected resectable cases.
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Sung Hwan
SH
Lee
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Sung Hyun
SH
Kim
Department of Surgery, Yongin Severance Hospital, Yongin, Korea.
Jin Hong
JH
Lim
Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
Sung Hoon
SH
Kim
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Jin Gu
JG
Lee
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Dae Joon
DJ
Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Gi Hong
GH
Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Jin Sub
JS
Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Kyung Sik
KS
Kim
Colorectal cancer; Liver cancer; Lung cancer; Metastasis