PULMONARY METASTASES FROM COLORECTAL-CANC ER - RESULTS OF SURGERY

Objectives: Surgery has become a recognized therapeutic means in selec ted patients with isolated pulmonary metastases, with a 5-year surviva l rate of about 35%, but specific studies on the results and prognosis of surgery for pulmonary metastases from colorectal cancer remain rel atively rare. Methods: Between 1980 and 1998, 65 patients (34 men, 31 women, mean age 58.2 years) underwent 81 thoracic operations with cura tive intent (including 15 bilateral operations and 7 incomplete resect ions) far pulmonary metastases from colorectal cancer. Results: The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 27% and 22% respectively. The site of the prim ary tumor (colon or rectum), the disease-free interval, previous resec tion(s) of hepatic metastases, and the size of pulmonary metastases we re not found to the have a statistically significant influence on prog nosis. On the other hand, the quality of resection (complete or incomp lete) (p < 0.001), the number of resected pulmonary metastases (p = 0. 016), and the preoperative carcino-embryonic antigen level (p < 0.001) were found to be highly significant prognostic factors. Conclusion: C omplete resection of pulmonary metastases from colorectal cancer seems to prolong survival in a significant number of patients, and the resu lts from this study should help to select those who may benefit ham th is treatment.