COLORECTAL LUNG METASTASES - RESULTS OF S URGICAL RESECTION

Objective. - The aim of this work was to determine the long term resul ts and the prognostic factors after surgical resection of pulmonary me tastases from colorectal cancers. Methods. - Clinal status after surge ry and survival were studied in 101 consecutive patients undergoing lu ng resection for pulmonary metastases from colorectal carcinoma betwee n 1970 and 1993. Prognostic factors were evaluated according to surgic al design. Mean interval between colon resection and lung resection wa s 44 months. Fifty-nine patients had a solitary lesion, 17 had multipl e unilateral lesions and 25 multiple bilateral lesions. Eighteen patie nts had undergone previous surgery for localized extrapulmonary metast ases. A wedge resection was performed in 47 patients, lobectomy or bil obectomy in 40, pneumonectomy in 11 and biopsy in 3. Results. - There was no postoperative mortality and 5-year survival in complete resecti on was 21 %; all patients with incomplete resection or biopsy died wit hin 3 years. Significant prognostic factors were: complete resection, metachronous disease (vs synchronous metastases) and absence of lymph node involvement. The extent of the colorectal disease and the number of resected metastases did not influence prognosis. Survival for patie nts with resected extrapulmonary disease was not significantly differe nt as compared with patients with only pulmonary metastases. Eleven pa tients had repeat pulmonary resections, 6 of these patients are curren tly alive, 3 of them more than 3 years after the second pulmonary rese ction. Conclusions. - We conclude that resection of colorectal lung me tastases is safe and effective, that resectable extra-pulmonary diseas e does not contra-indicate pulmonary resection and that repeal thoraco tomy is warranted in selected patients with recurrent lung metastases.