Abstract
Introduction
The purpose of this study was to identify independent unfavorable prognostic factors for patients who underwent video-assisted thoracoscopic surgery for resection of pulmonary metastases from colorectal cancer (CRC).
Methods
Between January 2004 and December 2013, 131 patients with pulmonary metastases from CRC underwent the aforementioned procedure for the first time at our institution. Kaplan–Meier survival curves and log-rank tests were used to analyze the survival rates. Multivariate analyses were performed using the Cox proportional hazards regression model.
Results
The 5-year disease-free survival (DFS) rate of these 131 patients was 34 %. Multivariate analyses showed two variables to be independent significant unfavorable prognostic factors for DFS: preoperative high serum carcinoembryonic antigen (CEA) level and a greater number of pulmonary metastases. According to subgroup analyses that combined these two risk factors, the 5-year DFS rates were 58, 25, and 12 % for patients with 0, 1, or 2 risk factors, respectively.
Conclusion
In patients who underwent video-assisted thoracoscopic surgery for pulmonary metastases from CRC, we identified two independent unfavorable prognostic factors for DFS: a high CEA level before metastasectomy and a greater number of pulmonary metastases. These factors can be used to identify higher- and lower-risk subgroups, which may help with selecting patients who would benefit the most from video-assisted thoracoscopic pulmonary metastasectomy.
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Abbreviations
- CRC:
-
Colorectal cancer
- VATS:
-
Video-assisted thoracoscopic surgery
- CT:
-
Computed tomography
- CEA:
-
Carcinoembryonic antigen
- FEV1:
-
Forced expiratory volume in 1 s
- FVC:
-
Forced vital capacity
- DFI:
-
Disease-free interval
- DFS:
-
Disease-free survival
- OS:
-
Overall survival
- IRLM:
-
International Registry of Lung Metastases
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No patient consent was required as the research is a retrospective chart review and no personally identifiable information was included in the manuscript.
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All work included in the manuscript is performed at Fujita Health University School of Medicine, Toyoake, Aichi, Japan. The research was approved by the Internal Review Board of the institution.
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Maeda, R., Suda, T., Hachimaru, A. et al. Video-Assisted Thoracoscopic Pulmonary Metastasectomy in Patients with Colorectal Cancer: A Recent 10-Year Single-Institution Experience. World J Surg 40, 1318–1323 (2016). https://doi.org/10.1007/s00268-016-3424-2
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DOI: https://doi.org/10.1007/s00268-016-3424-2