Liver and lung resection for colorectal metastasis


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Aim:  To examine the survival benefit of liver and lung resection for colorectal metastasis and the potential prognostic factors that affect patient survival.

Methods:  All patients who had resection of lung or liver metastasis for colorectal metastasis in Queen Elizabeth Hospital, Hong Kong from 1995 to 2004 were retrospectively reviewed. The overall and disease-free survival was analysed, in particularly between liver and lung metastasis. All factors that may have affected the survival were entered into Cox's proportional hazards regression model to identify significant variables associated with survival.

Results:  At 5 years, the overall survival of patients who had resection of lung and liver metastasis was 44% and 38%, respectively; the disease-free survival was 26% and 24%, respectively. Overall and disease-free survival of patients with resection of lung metastasis was comparable to those with resection of liver metastasis. The differentiations of primary tumour and time to metastasis were shown to be significant prognostic factors influencing overall survival. Those patients with systemic chemotherapy after resection of colorectal metastasis demonstrated a significantly higher probability of overall survival.

Conclusion:  Resection of lung and liver metastases from colorectal origin was safe and both procedures improved survival. The use of chemotherapy after resection of metastasis significantly improved the overall survival.