RESECTION OF BOTH HEPATIC AND PULMONARY METASTASES IN PATIENTS WITH COLORECTAL-CARCINOMA

BACKGROUND. More than 40% of patients who undergo curative resection o f advanced colorectal carcinoma can be expected to have recurrence of the disease. The most frequent sites of recurrence are the liver (33% of patients) and lung (22%). Interest has therefore focused on treatin g hepatic or pulmonary metastases, or both, to improve the outcomes of these patients. Although surgical resection has become an increasingl y accepted treatment for resectable localized hepatic or localized pul monary metastases from colorectal carcinoma, the value of aggressive s urgery for the removal of both hepatic and pulmonary metastases from p atients with primary colorectal carcinoma remains to be clarified. MET HODS, Data on 30 patients who had undergone resection of both hepatic and pulmonary metastases from colorectal carcinoma were included in th e study. RESULTS. Independent, significant prognostic features were fo und to be the time that hepatic or pulmonary metastases occurred and t he distribution of pulmonary metastases. Median survival times were 30 months (range, 7-108 months) after resection of both hepatic and pulm onary metastases and 48.5 months (range, 11-149 months) after excision of the primary colorectal tumor. Actuarial 1-, 3-, and 5-year surviva l after resection of both hepatic and pulmonary metastases was 86.7%, 49.3%, and 43.8%, respectively. No perioperative mortality occurred. T here were three cases of minor morbidity, which the authors considered acceptable. CONCLUSIONS, Resection of both hepatic and pulmonary meta stases from colorectal carcinoma may help to prolong the survival of a small group of patients with these metastases. (C) 1998 American Canc er Society.