BACKGROUND: Although simple lung or liver metastasectomy from colorectal cancer have proved effective in selected patients, the value of simultaneous biorgan metastasectomies is still debated. STUDY DESIGN: Of 155 patients who underwent operation for lung or liver colorectal metastases between March 1987 and December 1998, we retrospectively reviewed 29 patients who presented simultaneous (n = 12) or sequential liver-->lung (n = 10) and lung-->liver (n = 7) metastases. All metastases were successfully resected in a total of 56 separate procedures. In 35 thoracic procedures, 45 metastases were removed by wedge resection (n = 36) or lobectomy (n = 9). In addition, 47 liver metastases were resected with wedge (n = 24), segmentectomy (n 13), or lobectomy (n = 10). There were no perioperative deaths and the morbidity rate was low (10.7%). All patients were followed for a minimum of 3 years. Factors possibly influencing survival were evaluated by univariate and subsequently by multivariate analyses. RESULTS: Median survival from the second metastasectomy was 41 months, with a 5-year survival rate of 51.3%. Risk factor distribution among the three metastastic pattern groups was insignificant. Premetastasectomy elevated levels of both CEA and CA19-9 (p = 0.0001), and mediastinal or celiac lymph node status (p = 0.03) were significantly associated with survival in the univariate analysis, although number of metastasectomies, disease-free interval, and simultaneous versus sequential diagnosis were not. In the multivariate analysis, only elevated CEA plus CA19-9 (p = 0.01) was significantly associated with survival. CONCLUSIONS: We conclude that either simultaneous or sequential lung and liver metastasectomy can be successfully treated by surgery. Poor results were obtained in the presence of high levels of CEA plus CA19-9

Mineo, T.c., Ambrogi, V., Tonini, G., Bollero, P., Roselli, M., Mineo, D., et al. (2003). Longterm results after resection of simultaneous and sequential lung and liver metastases from colorectal carcinoma. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 197(3), 386-391 [10.1016/S1072-7515(03)00387-9].

Longterm results after resection of simultaneous and sequential lung and liver metastases from colorectal carcinoma

MINEO, TOMMASO CLAUDIO;AMBROGI, VINCENZO;BOLLERO, PATRIZIO;ROSELLI, MARIO;MINEO, DAVIDE;
2003-01-01

Abstract

BACKGROUND: Although simple lung or liver metastasectomy from colorectal cancer have proved effective in selected patients, the value of simultaneous biorgan metastasectomies is still debated. STUDY DESIGN: Of 155 patients who underwent operation for lung or liver colorectal metastases between March 1987 and December 1998, we retrospectively reviewed 29 patients who presented simultaneous (n = 12) or sequential liver-->lung (n = 10) and lung-->liver (n = 7) metastases. All metastases were successfully resected in a total of 56 separate procedures. In 35 thoracic procedures, 45 metastases were removed by wedge resection (n = 36) or lobectomy (n = 9). In addition, 47 liver metastases were resected with wedge (n = 24), segmentectomy (n 13), or lobectomy (n = 10). There were no perioperative deaths and the morbidity rate was low (10.7%). All patients were followed for a minimum of 3 years. Factors possibly influencing survival were evaluated by univariate and subsequently by multivariate analyses. RESULTS: Median survival from the second metastasectomy was 41 months, with a 5-year survival rate of 51.3%. Risk factor distribution among the three metastastic pattern groups was insignificant. Premetastasectomy elevated levels of both CEA and CA19-9 (p = 0.0001), and mediastinal or celiac lymph node status (p = 0.03) were significantly associated with survival in the univariate analysis, although number of metastasectomies, disease-free interval, and simultaneous versus sequential diagnosis were not. In the multivariate analysis, only elevated CEA plus CA19-9 (p = 0.01) was significantly associated with survival. CONCLUSIONS: We conclude that either simultaneous or sequential lung and liver metastasectomy can be successfully treated by surgery. Poor results were obtained in the presence of high levels of CEA plus CA19-9
2003
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
English
Con Impact Factor ISI
CA 19-9 antigen; carcinoembryonic antigen; adult; aged; cancer patient; cancer survival; colorectal carcinoma; controlled study; female; follow up; human; liver metastasis; liver surgery; lobectomy; long term care; lung metastasis; lung surgery; major clinical study; male; metastasectomy; multivariate analysis; perioperative period; priority journal; retrospective study; review; risk factor; surgical mortality; survival rate; treatment outcome; article; colorectal tumor; liver resection; liver tumor; lung resection; lung tumor; metastasis; middle aged; pathology; survival; Aged; Colorectal Neoplasms; Female; Hepatectomy; Humans; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Pneumonectomy; Retrospective Studies; Survival Analysis; Treatment Outcome
Mineo, T.c., Ambrogi, V., Tonini, G., Bollero, P., Roselli, M., Mineo, D., et al. (2003). Longterm results after resection of simultaneous and sequential lung and liver metastases from colorectal carcinoma. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 197(3), 386-391 [10.1016/S1072-7515(03)00387-9].
Mineo, Tc; Ambrogi, V; Tonini, G; Bollero, P; Roselli, M; Mineo, D; Nofroni, I
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/50060
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