A team from Rochester, Minnesota, USA, investigated the results of surgical resection for both hepatic and pulmonary metastases secondary to colorectal cancer.
The researchers reviewed the records of all patients who underwent surgical resection between 1980 and 1998.
A total of 58 patients underwent resection for the aforementioned conditions. All patients had local control of their primary cancer before metastasectomy. There were no operative deaths. Morbidity occurred in 12% of patients. Follow-up was complete in all patients, with a median duration of 62 months.
The 5- and 10-year survivals were found to be 30% and 16%, respectively.
|Survival after resection of metastases:|
5 years: 30%
10 years: 16%
|Annals of Thoracic Surgery|
A pre-metastasectomy carcinoembryonic antigen level greater than 5 ng/ml increased the risk of early death. Neither the number of pulmonary lesions, nor the time interval between the primary surgery and the metastasectomy, had a significant impact on survival.
At 5 years, 55% of patients were free of disease.
4 patients had lymph node involvement at the time of pulmonary resection, and all four patients died within 22 months of their pulmonary metastasectomy.
Dr James R. Headrick, of the Mayo Foundation, Rochester, said on behalf of the group, "Resection of both hepatic and pulmonary metastases secondary to colorectal cancer in highly selected patients is safe and results in long-term survival.
"Thoracic lymph node involvement and elevated carcinoembryonic antigen levels before pulmonary metastasectomy are associated with reduced survival."