title: [Examination to Determine Predictive Factors of Effectiveness of Surgical Treatment for Both Pulmonary and Hepatic Metastasis from Colorectal Cancer].
abstract: In recent years, several colorectal patients with pulmonary and hepatic metastasis, if resectable, have been found to experience long-term survival. In the present study, we extracted predictive factors, selected patients for whom a good prognosis could be anticipated, and examined the indications for surgery. From January 1986 to December 2014, we conducted a multivariate analysis of 18 patients who underwent surgical resection for pulmonary and hepatic metastases, with overall survival(OS)as the dependent variable, and clinicopathological factors as explanatory variables. The 5-year survival rate of the pulmonary and hepatic resection group was 32.0%. No significant difference was noted observed in CEA levels, number of metastatic pulmonary nodes, tumor diameter, synchronic, and metachronous tumors. A significant difference was only observed for disease-free interval(DFI)following resection of the primary lesion. The area under the receiver operating characteristic(ROC)curve revealed that the optimum cut-off value following resection of the primary lesion was a DFI of 762 days. When comparing the OS of the group with DFI<762 days and the group with DFI<762 days using a Kaplan-Meier curve, we found that survival was significantly prolonged. Therefore, surgery is indicated for colorectal cancer patients with pulmonary and hepatic metastasis, and who have DFI>2 years following resection of the primary lesion, and prolonged survival can be expected following surgery.
authors.affiliation: Dept. of Gastroentestinal and Pediatric Surgery, Tokyo Medical University.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Matsudo
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ishizaki
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Shigoka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Enomoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hisada
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kasuya
authors.forename: Kenji
authors.initials: K
authors.lastname: Katsumata
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D011013:Pneumonectomy; D016896:Treatment Outcome