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Long-term survival after hepatic and pulmonary resection of colorectal cancer metastases

Authors

  • Isabelle Sourrouille MD,

    1. Department of Thoracic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
    2. Department of Hepato-Biliary and Pancreatic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Pierre Mordant MD,

    1. Department of Thoracic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Léon Maggiori MD,

    1. Department of Colorectal Surgery, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Safi Dokmak MD,

    1. Department of Hepato-Biliary and Pancreatic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Guy Lesèche MD, PhD,

    1. Department of Thoracic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Yves Panis MD, PhD,

    1. Department of Colorectal Surgery, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Jacques Belghiti MD,

    1. Department of Hepato-Biliary and Pancreatic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
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  • Yves Castier MD, PhD

    Corresponding author
    1. Department of Thoracic, Groupe Hospitalier Bichat-Beaujon, Assistance Publique—Hôpitaux de Paris, Paris, Clichy, France
    • Correspondence to: Prof. Yves Castier, MD, PhD, Department of Thoracic and Vascular Surgery Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France. Fax: +33-1-40-25-69-62. E-mail: yves.castier@bch.aphp.fr

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Abstract

Background

Recent changes in adjuvant therapies improved the prognosis of metastatic colorectal cancers. Curative resection may be considered, even for both pulmonary and hepatic metastases, but prognostic factors are not well identified.

Methods

From 1995 to 2010, 69 patients had curative resection of pulmonary metastases of colorectal cancer; 31 had also hepatic metastases. Pulmonary and hepatic resection occurred in 2 steps (87%). We studied overall and disease-free survival and prognostic factors.

Results

Primary tumor location was the rectum in 10 cases (32%). Pulmonary metastases were synchronous in 5 (16%) and bilateral in 6 (19%). One patient (3%) died after pulmonary surgery. One (3%) had positive surgical margins for pulmonary metastases. Median overall survival was 44 months (5-year rate = 36%); median disease-free survival was 22 months (5-year rate = 10%). Factors linked to impaired survival were rectal primary tumor (P = 0.04) and bilateral pulmonary metastases (P = 0.02) for overall survival, and pulmonary metastase≥20 mm (P = 0.04) for disease-free survival.

Conclusion

When associated to adjuvant therapy, complete resection of pulmonary and hepatic metastases of colorectal cancer allows long-term survival in one third of the patients. J. Surg. Oncol. 2013 108:220–224. © 2013 Wiley Periodicals, Inc.

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