Pulmonary Metastasectomy For 29 Patients With Colorectal Carcinoma: A Single Center Experience

INTRODUCTION: Synchronous or metachoronous distant metastasis develops in approximately 50-60% of patients with colorectal cancer during the clinical course. Surgical resection of the hepatic and/or pulmonary metastasis of colorectal cancers significantly extends disease-free survival (DFS) and overall survival (OS) rates, and thus has been applied more broadly in recent years.
METHODS: In this study, 29 patients who were treated at the Dokuz Eylül University Medical Faculty Hospital and who had received a metastasectomy due to a lung metastasis related to colorectal cancer were evaluated. Information on the patients was obtained retrospectively.
RESULTS: Twenty-four (82.8%) patients had an isolated lung metastasis and 5 (17.2%) had both lung and liver metastasis. Resection was performed on all patients for lung metastasis, and a lung+liver metastasectomy was performed on 5 (17.2%). For the entire patient group, the median OS was 57 months (SD± 4 months), and 1, 3, and 5 year survival rates were 96%, 92% and 49%, respectively. In patients who received follow-up treatment after undergoing the metastasectomy operation and who did not have lesions, the median DFS was 31 months (SD± 3 months), and 1, 3, and 5 year DFS rates were 86.3%, 42% and 1%, respectively. In patients who received wedge resection treatment, the median OS was 58 months (SD± 5 months), and for the patients who received lobectomy treatment, the median OS was 50 months (SD± 2 months). In the evaluations made according to the resection type, median OS was 66 months (SD± 5 months) in patients who had R0 resection and 47 months (SD± 7 months) in patients who had R1 resection.
DISCUSSION AND CONCLUSION: Our results show that surgical resection, particularly an R0 resection of lung metastasis in colorectal cancer patients contributes to extended patient OS time.

Yirmidokuz Kolon Kanserli Hastada Akciðer Metastezektomi: Tek Merkez Deneyimi

GÝRÝÞ ve AMAÇ: Kolorektal kanserli hastalarýn yaklaþýk olarak %50-60'ýnda senkron veya metakron uzak metastazlar izlenmektedir. Kolorektal kanserlerin hepatik ve pulmoner metastazlarýnýn cerrahi rezeksiyonu hastalýksýz saðkalým (DFS) ve genel saðkalýmý (OS) anlamlý düzeyde uzatmakta ve böylece son yýllarda yaygýn olarak uygulanmaktadýr.
YÖNTEM ve GEREÇLER: Bu araþtýrmada, Dokuz Eylül Üniversitesi Týp Fakültesi Hastanesi'nde tedavi gören ve kolorektal kanserlere baðlý akciðer metastazlarý nedeniyle metastazektomi uygulanan 29 hasta deðerlendirildi. Hastalara ait bilgiler retrospektif olarak elde edildi.
BULGULAR: Hastalarýn 24'ü (%82.8) izole akciðer metastazý, gerikalan 5’i (%17.2) ise hem akciðer hem karaciðer metastazýna sahipti. Çalýþmaya alýnan hastalarýn tümüne akciðer metastazýna yönelik rezeksiyon uygulanýrken, 5 (%17.2) hastaya ise akciðer+karaciðer metastazektomisi uygulanmýþtý. Tüm hasta grubunda ortanca OSx 57 ay (SD± 4 ay), 1, 3 ve 5 yýllýk saðkalým oranlarý sýrasýyla %96, %92 ve %49 olarak tespit edildi. Metastazektomi operasyonu sonrasý izlenen lezyonu olmayan hastalarda ortanca DFS 31 ay (SD± 3 ay), 1, 3 ve 5 yýllýk DFS oranlarý sýrasýyla %86, %42 ve %1 olarak saptandý. Metastazektominin þekline göre OS deðerlendirildiðinde wedge rezeksiyon yapýlanlarda ortanca OS 58 ay (SD± 5 ay), lobektomi yapýlanlarda ise 50 ay (SD± 2 ay) olarak bulundu. Rezeksiyon türüne göre OS deðerlendirildiðinde R0 rezeksiyon yapýlanlarda ortanca OS 66 ay (SD± 5 ay), R1 rezeksiyon yapýlanlarda ise ortanca OS 47 (SD± 7 ay) ay olarak bulundu.
TARTIÞMA ve SONUÇ: Sonuçlarýmýz kolorektal kanser akciðer metastazlarýnýn cerrahi rezeksiyonunun, özellikle R0 rezeksiyonun OS süresinin uzamasýna katký saðladýðýný göstermektedir.