title: Post-pulmonary metastasectomy prognosis after curative resection for colorectal cancer.
abstract: OBJECTIVE
  We aimed to compare disease-free survival after pulmonary metastasectomy to that after hepatic metastasectomy, and to identify prognostic factors after pulmonary metastasectomy.
  
  
  RESULTS
  Between 2005 and 2015, 129 patients underwent resection of isolated metachronous lung metastases from colorectal cancer. Three-year DFS after pulmonary metastasectomy was similar to that after hepatic metastasectomy (50.7% vs. 45.5%, respectively; p=0.58). Rectal cancer (hazard ratio [HR]: 2.04, 95% confidence interval [CI]: 1.09-3.79; p=0.03) and ≥2 metastases (HR: 2.17, 95% CI: 1.28-3.68; p=0.004) were independent adverse risk factors associated with disease-free survival after pulmonary metastasectomy on multivariate analysis. Three-year DFS for colon vs. rectal cancer patients was 72.5% vs. 42.6%, respectively (p=0.04). The number of lung metastases was an independent risk factor for DFS after pulmonary metastasectomy in rectal cancer patients.
  
  
  METHODS
  Patients who underwent lung metastasectomy after curative resection of colorectal cancers were investigated. Disease-free survival (DFS) after pulmonary metastasectomy was compared to that after hepatic metastasectomy, which has a relatively well-known prognosis. Multivariate Cox proportional hazards analysis was performed to identify clinical variables predictive of survival after pulmonary metastasectomy.
  
  
  CONCLUSIONS
  Disease-free survival rates after resection of lung vs. liver metastases arising from colorectal cancers are similar. However, lung metastases specifically from rectal cancers produce poorer DFS rates. Primary tumor location must be considered for pulmonary metastasis treatment and follow-up in colorectal cancer patients.
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Jee Yeon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: In Ja
authors.initials: IJ
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Hyeong Ryul
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Dong Kwan
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Jong Lyul
authors.initials: JL
authors.lastname: Lee
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Chan Wook
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Seok-Byung
authors.initials: SB
authors.lastname: Lim
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Jung Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Jin Cheon
authors.initials: JC
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics; D002648:Child; D015179:Colorectal Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D059146:Metastasectomy / Q000379:methods; D053842:Microsatellite Instability; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011184:Postoperative Period; D011379:Prognosis; D019233:Retreatment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: colorectal cancer; disease free survival; pulmonary metastasectomy