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Combined resection of colorectal hepatic–pulmonary metastases shows improved outcome over chemotherapy alone

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Abstract

Background

The objective of this retrospective study was to assess the survival of patients after resection of hepatic and pulmonary colorectal metastases to identify predictors of long-term survival.

Methods

Patients receiving chemotherapy alone were compared to patients receiving surgery and chemotherapy in a matched-pair analysis with the following criteria: UICC stage, grading, and date of initial primary tumor occurrence.

Results

A total of 30 patients with liver and lung metastases of colorectal carcinoma underwent resection. In 20 cases, complete resection was achieved (median survival, 67 months). Incomplete resection and preoperatively elevated carcinoembryonic antigen (CEA) levels are independent risk factors for reduced survival. Patients developing pulmonary metastases prior to hepatic metastases had the worst prognosis. Surgical resection significantly increased survival compared to chemotherapy alone in matched-pair analysis (65 vs. 30 months, p = 0.03).

Conclusions

Incomplete resection and elevated CEA levels are predictors of poor outcome. Matched-paired analysis confirmed that surgical resection in combination with chemotherapy appears to be superior to chemotherapy alone.

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Acknowledgments

This work was supported by a grant from the Chiles Foundation, Portland, OR. The Chiles Foundation is a nonprofit research institution supporting biomedical research. The Chiles Foundation had no influence on the design or conduct of the study, the collection, management, analysis, and interpretation of the data, or the preparation, review, or approval of the manuscript.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of General Thoracic Surgery, University of Munich–Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany

    Georgios Meimarakis, Martin Angele, Rolf Weidenhagen, Gerhard Preissler, Karl-Walter Jauch, Rudolf A. Hatz & Hauke Winter

  2. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Claudius Conrad

  3. Department of Surgery, Traunstein Hospital, Traunstein, Germany

    Rolf Schauer

  4. Department of Medical Informatics, Biometry, and Epidemiology, University of Munich, Munich, Germany

    Alexander Crispin & Max Wiedemann

  5. Department of Oncology and Comprehensive Cancer Center, University of Munich–Grosshadern, Munich, Germany

    Clemens Giessen, Volker Heinemann & Sebastian Stintzing

Authors
  1. Georgios Meimarakis
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  2. Martin Angele
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  3. Claudius Conrad
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  14. Hauke Winter
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Corresponding author

Correspondence to Hauke Winter.

Additional information

Authors’ contributions

• Study conception and design: Georgios Meimarakis, Martin Angele, Hauke Winter

• Acquisition of data: Georgios Meimarakis, Rolf Schauer, Clemens Giessen, Max Wiedemann

• Analysis and interpretation of data: Georgios Meimarakis, Alexander Crispin

• Drafting of manuscript: Martin Angele, Claudius Conrad, Sebastian Stintzing, Hauke Winter

• Critical revision of manuscript: Rolf Weidenhagen, Clemens Giessen, Gerhard Preissler, Karl-Walter Jauch, Volker Heinemann, Rudolf A. Hatz

G. Meimarakis and M. Angele contributed equally to this work.

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Meimarakis, G., Angele, M., Conrad, C. et al. Combined resection of colorectal hepatic–pulmonary metastases shows improved outcome over chemotherapy alone. Langenbecks Arch Surg 398, 265–276 (2013). https://doi.org/10.1007/s00423-012-1046-1

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  • DOI: https://doi.org/10.1007/s00423-012-1046-1

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