title: Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer.
abstract: Although wedge resection is the most common surgical procedure for pulmonary metastases from colorectal cancer, there are few reports about segmentectomy for colorectal metastasectomy.
  
  
  
  This was a subset analysis of a Japanese nationwide retrospective study of resected pulmonary metastases from colorectal cancer. The study included 553 patients who underwent segmentectomies ( n  = 98) or wedge resections ( n  = 455) without preoperative chemotherapy between January 2004 and December 2008. Recurrence patterns, recurrence-free survival and overall survival were analysed for each procedure.
  
  
  
  As for the patients' background factors, only the median size of resected metastases was different between patients with segmentectomies (median 18 mm, range 5-50 mm) and wedge resections (14 mm, 5-51 mm) ( P  < 0.001). Prolonged air leak developed more frequently in those undergoing segmentectomy compared with wedge resection (5.1% vs 1.8%) ( P  = 0.048). The resection-margin recurrence rate was higher in patients who underwent wedge resection compared with segmentectomy (7.3% vs 2.0%; P  = 0.035). The 5-year recurrence-free survival was 48.8% in patients with segmentectomy and 36.0% in patients with wedge resections. The 5-year overall survival was 80.1% in patients with segmentectomy and 68.5% in patients with wedge resection. Multivariable analysis revealed that the surgical procedure, segmentectomy, was a significant favourable factor for recurrence (hazard ratio: 0.63, 95% confidence interval: 0.44-0.87, P  = 0.005), but not for overall survival (hazard ratio: 0.65, 95% confidence interval: 0.38-1.05, P  = 0.080).
  
  
  
  Segmentectomy demonstrated a good efficacy with less resection-margin recurrence in patients with resectable pulmonary-limited metastasis from colorectal cancer.
authors: Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors: Satoshi
authors: S
authors: Shiono
authors: Department of Surgery, School of Medicine, University Hospital Mizonokuchi, Teikyo University, Kanagawa, Japan.
authors: Takehiro
authors: T
authors: Okumura
authors: Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Narikazu
authors: N
authors: Boku
authors: Department of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan.
authors: Tomoyuki
authors: T
authors: Hishida
authors: Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors: Yasuhisa
authors: Y
authors: Ohde
authors: Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors: Yukinori
authors: Y
authors: Sakao
authors: Department of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
authors: Katsuo
authors: K
authors: Yoshiya
authors: Division of Gastroenterology Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Ichinosuke
authors: I
authors: Hyodo
authors: Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan.
authors: Keita
authors: K
authors: Mori
authors: General Thoracic Surgery, School of Medicine, Kyorin University, Tokyo, Japan.
authors: Haruhiko
authors: H
authors: Kondo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D059146:Metastasectomy / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Metastasectomy; Segmentectomy; Wedge resection