Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Japan.
Am J Surg. 2011 Oct;202(4):419-26. doi: 10.1016/j.amjsurg.2010.08.016. Epub 2011 Aug 6.
The outcomes after repeat pulmonary resection for colorectal cancer (CRC) and the factors associated with the prognosis of these patients remain uncharacterized.
Data on 156 patients who underwent curative resection of pulmonary metastasis from CRC were reviewed. Repeat pulmonary resection was performed in 25 patients; the present study examined the outcomes and factors associated with prognosis after repeat pulmonary resection.
The 5-year survival rate after the first pulmonary resection was 56.2%. A multivariate analysis identified a histological type other than well-differentiated adenocarcinoma, a high prethoracotomy serum carcinoembryonic antigen (CEA) level, and the presence of hilar or mediastinal lymph node metastasis as poor prognostic factors for the first pulmonary resection. The 5-year survival rate after repeat pulmonary resection was 42.1%. Hilar or mediastinal lymph node metastasis at the time of the repeat resection was significantly associated with poor survival.
Repeat pulmonary resection for metastatic CRC provides satisfactory outcomes. Hilar or mediastinal lymph node involvement is consistently associated with a poor prognosis after the first and repeat pulmonary resections.
结直肠癌（CRC）患者多次肺切除术后的结果以及与这些患者预后相关的因素尚不清楚。
回顾了 156 例接受结直肠转移灶根治性切除术患者的数据。25 例患者接受了再次肺切除术；本研究探讨了再次肺切除术后的结果和与预后相关的因素。
首次肺切除术后 5 年生存率为 56.2%。多因素分析发现，非高分化腺癌组织学类型、术前血清癌胚抗原（CEA）水平高、存在肺门或纵隔淋巴结转移是首次肺切除术的不良预后因素。再次肺切除术后 5 年生存率为 42.1%。再次切除时存在肺门或纵隔淋巴结转移与生存不良显著相关。
转移性 CRC 的再次肺切除术可获得满意的结果。首次和再次肺切除术后，肺门或纵隔淋巴结受累始终与预后不良相关。
