title: Recent improvement of survival prognosis after pulmonary metastasectomy and advanced chemotherapy for patients with colorectal cancer.
abstract: OBJECTIVE
  New chemotherapeutic regimens (i.e. FOLFOX or FOLFIRI with molecular targeted drugs) have improved the prognosis of patients with unresectable or recurrent colorectal cancer. To estimate the prognostic impact of these chemotherapies, we examined the chronological change in survival rates of patients who underwent pulmonary metastasectomy for colorectal cancer metastasis.
  
  
  METHODS
  Using a large database, we conducted a retrospective, multi-institutional study to collect data of 1223 eligible patients from 26 institutions who had undergone pulmonary metastasectomy with curative intent. We divided those patients who underwent metastasectomy in different time periods according to the major trend of chemotherapy regimens for recurrent colorectal cancer: those who underwent metastasectomy between 1990 and 1999 ( N  = 451, Group A), between 2000 and 2004 ( N  = 433, Group B) or between 2005 and 2007 ( N  = 339, Group C).
  
  
  RESULTS
  Five-year overall survival rates after metastasectomy were 45% in Group A, 56% in Group B and 66% in Group C ( P  < 0.0001) whereas rates after metastasectomy plus chemotherapy were 32% in Group A, 47% in Group B and 70% in Group C ( P  = 0.0059). The prognosis of patients who underwent both metastasectomy and chemotherapy in Group C was significantly better than that of the other two groups. Overall survival of patients who did not receive chemotherapy was not significantly different between the groups.
  
  
  CONCLUSIONS
  Survival rates of patients after pulmonary metastasectomy for colorectal cancer metastasis who underwent chemotherapy have increased over the years. It implies that newer chemotherapy regimens might have had a positive impact on these patients.
authors.affiliation: Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.affiliation: Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Iida
authors.affiliation: Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation, Tokyo, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Okumura
authors.affiliation: Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Asamura
authors.affiliation: Department of Thoracic Surgery, National Defense Medical College, Saitama, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozeki
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: Division of Thoracic Surgery, Tochigi Cancer Center, Tochigi, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Matsuguma
authors.affiliation: Department of Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Chida
authors.affiliation: Department of Chest Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsuka
authors.affiliation: Division of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kawamura
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008297:Male; D059146:Metastasectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: Adjuvant chemotherapy; Colorectal cancer; Metastasectomy; Pulmonary metastasis; Survival rate