Maeda Ryo, Isowa Noritaka, Onuma Hideyuki, Miura Hiroshi, Harada Tomoya, Touge Hirokazu, Tokuyasu Hirokazu, Kawasaki Yuji
Division of Thoracic Surgery, Matsue Red Cross Hospital, 200 Horomachi, Matsue, Shimane 690-8506, Japan.
Interact Cardiovasc Thorac Surg. 2009 Oct;9(4):640-4. doi: 10.1510/icvts.2009.202598. Epub 2009 Jul 27.
A pulmonary resection of metastatic colorectal carcinoma is an accepted method of treatment. The purpose of this study was to confirm the role of resections for pulmonary metastases from colorectal carcinoma, and to determine the clinical course, outcome, and prognostic factors after surgery. A retrospective analysis was conducted of the records of all patients with pulmonary metastases from colorectal carcinoma who underwent a surgical resection between 1995 and 2008, at a single surgical center. The overall 5-year survival rate was 74%. Multivariate Cox analysis demonstrated that the number of pulmonary metastases (HR: 9.40, 95% confidence interval (CI): 1.08-82.2, P=0.0428) and prethoracotomy carcinoembryonic antigen (CEA) level (HR: 9.79, 95% CI: 1.11-86.8, P=0.0404) were statistically significant predictors of survival after the first pulmonary metastasectomy. In addition, a second resection for recurrent metastases was performed in eight patients, and a third resection was done in one patient. There were no major postoperative complications among the patients who underwent second or third resections. Pulmonary resections are considered to be a safe and effective treatment in selective patients.
肺转移性结直肠癌切除术是一种公认的治疗方法。本研究的目的是确认结直肠癌肺转移灶切除术的作用,并确定手术后的临床病程、结局及预后因素。对1995年至2008年在单一外科中心接受手术切除的所有结直肠癌肺转移患者的记录进行了回顾性分析。总体5年生存率为74%。多变量Cox分析表明,肺转移灶数量(风险比:9.40,95%置信区间:1.08 - 82.2,P = 0.0428)和开胸术前癌胚抗原(CEA)水平(风险比:9.79,95%置信区间:1.11 - 86.8,P = 0.0404)是首次肺转移灶切除术后生存的统计学显著预测因素。此外,8例患者进行了复发性转移灶的二次切除,1例患者进行了三次切除。接受二次或三次切除的患者中无重大术后并发症。肺切除术被认为是选择性患者的一种安全有效的治疗方法。