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Survival after resection of liver and lung colorectal metastases in the era of modern multidisciplinary therapy

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Abstract

Purpose

Despite recent improvement of the outcomes of colorectal cancer (CRC), the benefits of resection and appropriate selection criteria in patients with both liver and lung metastases remain controversial. The aim of this study was to analyze the outcomes and prognostic factors for survival in patients who underwent both hepatic and pulmonary resection for CRC metastases in the era of modern multidisciplinary therapy.

Methods

A retrospective analysis of 43 consecutive patients who underwent both liver and lung resections for metastatic CRC at our institute from 2003 to 2011 was performed. All patients in this study had achieved cancer-free status after resection of the second metastatic site.

Results

Of the patients, 24 (56 %) had synchronous metastatic disease with their primary tumor. Twenty-seven patients had developed recurrence after resection of the second metastatic site. In 14 cases, re-metastasectomy was performed for recurrence. Fourteen patients received palliative chemotherapy after recurrence, and all of these patients received oxaliplatin and/or irinotecan-based chemotherapy. After resection of the second metastatic organ, the 5-year relapse-free and overall survival rates were 29.6 and 70.0 %, respectively. Patients with multiple lung metastases had worse relapse-free survival than patients with solitary lung metastases at first lung resection (p = 0.046).

Conclusions

Aggressive surgical resection and a combination of modern chemotherapeutic agents improve the survival of patients with lung and liver metastases from CRC. The presence of multiple lung metastases at resection suggests a poor prognosis.

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References

  1. Weitz J, Koch M, Debus J, Hohler T, Galle PR, Buchler MW (2005) Colorectal cancer. Lancet 365(9454):153–165

    Article  PubMed  Google Scholar 

  2. Galandiuk S, Wieand HS, Moertel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 174(1):27–32

    CAS  PubMed  Google Scholar 

  3. Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239(6):818–825, discussion 825–817

    Article  PubMed  Google Scholar 

  4. Doci R, Gennari L, Bignami P, Montalto F, Morabito A, Bozzetti F (1991) One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. Br J Surg 78(7):797–801

    Article  CAS  PubMed  Google Scholar 

  5. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230(3):309–318, discussion 318–321

    Article  CAS  PubMed  Google Scholar 

  6. Ohlsson B, Stenram U, Tranberg KG (1998) Resection of colorectal liver metastases: 25-year experience. World J Surg 22(3):268–276, discussion 276–267

    Article  CAS  PubMed  Google Scholar 

  7. Friedel G, Pastorino U, Buyse M, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam JB et al (1999) Resection of lung metastases: long-term results and prognostic analysis based on 5206 cases—the International Registry of Lung Metastases. Zentralbl Chir 124(2):96–103

    CAS  PubMed  Google Scholar 

  8. Inoue M, Ohta M, Iuchi K, Matsumura A, Ideguchi K, Yasumitsu T, Nakagawa K, Fukuhara K, Maeda H, Takeda S et al (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78(1):238–244

    Article  PubMed  Google Scholar 

  9. McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ (1992) Lung resection for colorectal metastases. 10-year results. Arch Surg 127(12):1403–1406

    Article  CAS  PubMed  Google Scholar 

  10. Okumura S, Kondo H, Tsuboi M, Nakayama H, Asamura H, Tsuchiya R, Naruke T (1996) Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 112(4):867–874

    Article  CAS  PubMed  Google Scholar 

  11. Brouquet A, Vauthey JN, Contreras CM, Walsh GL, Vaporciyan AA, Swisher SG, Curley SA, Mehran RJ, Abdalla EK (2011) Improved survival after resection of liver and lung colorectal metastases compared with liver-only metastases: a study of 112 patients with limited lung metastatic disease. J Am Coll Surg 213(1):62–69, discussion 69–71

    Article  PubMed  Google Scholar 

  12. Headrick JR, Miller DL, Nagorney DM, Allen MS, Deschamps C, Trastek VF, Pairolero PC (2001) Surgical treatment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg 71(3):975–979, discussion 979–980

    Article  CAS  PubMed  Google Scholar 

  13. Kobayashi K, Kawamura M, Ishihara T (1999) Surgical treatment for both pulmonary and hepatic metastases from colorectal cancer. J Thorac Cardiovasc Surg 118(6):1090–1096

    Article  CAS  PubMed  Google Scholar 

  14. Miller G, Biernacki P, Kemeny NE, Gonen M, Downey R, Jarnagin WR, D’Angelica M, Fong Y, Blumgart LH, DeMatteo RP (2007) Outcomes after resection of synchronous or metachronous hepatic and pulmonary colorectal metastases. J Am Coll Surg 205(2):231–238

    Article  PubMed  Google Scholar 

  15. Neeff H, Horth W, Makowiec F, Fischer E, Imdahl A, Hopt UT, Passlick B (2009) Outcome after resection of hepatic and pulmonary metastases of colorectal cancer. J Gastrointest Surg 13(10):1813–1820

    Article  PubMed  Google Scholar 

  16. Regnard JF, Grunenwald D, Spaggiari L, Girard P, Elias D, Ducreux M, Baldeyrou P, Levasseur P (1998) Surgical treatment of hepatic and pulmonary metastases from colorectal cancers. Ann Thorac Surg 66(1):214–218, discussion 218–219

    Article  CAS  PubMed  Google Scholar 

  17. Shah SA, Haddad R, Al-Sukhni W, Kim RD, Greig PD, Grant DR, Taylor BR, Langer B, Gallinger S, Wei AC (2006) Surgical resection of hepatic and pulmonary metastases from colorectal carcinoma. J Am Coll Surg 202(3):468–475

    Article  PubMed  Google Scholar 

  18. Isoniemi H, Osterlund P (2011) Surgery combined with oncological treatments in liver metastases from colorectal cancer. Scand J Surg 100(1):35–41

    CAS  PubMed  Google Scholar 

  19. Onaitis MW, Petersen RP, Haney JC, Saltz L, Park B, Flores R, Rizk N, Bains MS, Dycoco J, D’Amico TA et al (2009) Prognostic factors for recurrence after pulmonary resection of colorectal cancer metastases. Ann Thorac Surg 87(6):1684–1688

    Article  PubMed  Google Scholar 

  20. Gonzalez M, Robert JH, Halkic N, Mentha G, Roth A, Perneger T, Ris HB, Gervaz P (2012) Survival after lung metastasectomy in colorectal cancer patients with previously resected liver metastases. World J Surg 36(2):386–391

    Article  PubMed  Google Scholar 

  21. Iizasa T, Suzuki M, Yoshida S, Motohashi S, Yasufuku K, Iyoda A, Shibuya K, Hiroshima K, Nakatani Y, Fujisawa T (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82(1):254–260

    Article  PubMed  Google Scholar 

  22. Mullen JT, Ribero D, Reddy SK, Donadon M, Zorzi D, Gautam S, Abdalla EK, Curley SA, Capussotti L, Clary BM et al (2007) Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg 204(5):854–862, discussion 862–854

    Article  PubMed  Google Scholar 

  23. Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, Eder M, Fenoglio-Preiser CM, Napier J, Horne CH, Lopez MJ et al (1986) Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol 150(3):195–203

    Article  CAS  PubMed  Google Scholar 

  24. Ismaili N (2011) Treatment of colorectal liver metastases. World J Surg Oncol 9:154

    Article  PubMed Central  PubMed  Google Scholar 

  25. Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, Giacchetti S, Paule B, Kunstlinger F, Ghemard O et al (2004) Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 240(4):644–657, discussion 657–648

    PubMed  Google Scholar 

  26. Bismuth H, Adam R, Levi F, Farabos C, Waechter F, Castaing D, Majno P, Engerran L (1996) Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 224(4):509–520, discussion 520–502

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Shunsuke Tsukamoto, Yusuke Kinugasa, Tomohiro Yamaguchi & Akio Shiomi

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  1. Shunsuke Tsukamoto
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  2. Yusuke Kinugasa
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  3. Tomohiro Yamaguchi
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  4. Akio Shiomi
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Correspondence to Shunsuke Tsukamoto.

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Tsukamoto, S., Kinugasa, Y., Yamaguchi, T. et al. Survival after resection of liver and lung colorectal metastases in the era of modern multidisciplinary therapy. Int J Colorectal Dis 29, 81–87 (2014). https://doi.org/10.1007/s00384-013-1752-3

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  • DOI: https://doi.org/10.1007/s00384-013-1752-3

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