Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer.

AIM

To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer.

METHODS

Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chemotherapy was evaluated. Patients' outcome and predictive factors for overall survival were also investigated by univariate and multivariate analysis.

RESULTS

A total of 70 patients were included in the study. After standardized first-line chemotherapy, only 4 patients (5.7%) were converted to resectable disease. The median overall survival time in all patients was 19 mo (95% CI: 12.6-25.4), with a 2-year overall survival rate of 38.8%. No survival difference was found among different first-line chemotherapeutic regimens. Prognostic analysis demonstrated that only the first response assessment for first-line treatment was the independent factor for predicting overall survival. The median survival time in partial response, stable disease and progressive disease patients were 27 mo, 16 mo and 8 mo (P = 0.00001).

CONCLUSION

Pulmonary metastasectomy can only be performed in a small part of unresectable lung metastases patients after chemotherapy. Patients' first response assessment is an important prognostic factor.