Li Cong, Xu Qi, Chen Lei, Luo Cong, Ying Jieer, Liu Jinshi
Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.
Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.
Bull Cancer. 2017 Mar;104(3):232-236. doi: 10.1016/j.bulcan.2016.11.016. Epub 2017 Jan 4.
Pulmonary metastases occur in up to 25% of colorectal cancer (CRC) patients. Many studies have reported that pulmonary metastasectomy might increase 5-year survival of these patients. The aim of this study was to describe our experience with pulmonary metastasectomy for metastatic colorectal cancer and to explore the prognostic value of serum C-reactive protein (CRP) and other factors.
Between June 2002 and December 2013, the clinicopathological data of 88 patients who underwent resection of pulmonary metastases from colorectal carcinoma were retrospectively reviewed and analyzed. Clinical, investigative and operative data were prospectively collected. Overall survival (OS) was calculated from resection of pulmonary metastases to death.
There were 58 men and 30 women in this study, and their median age was 55 (range 31 to 85). Video-assisted thoracoscopic surgery (VATS) was performed in 59 cases (78%) and 29 patients (19%) underwent thoracotomy. Lung wedge resection and pulmonary lobectomy were performed in 52 (59.1%) and 36 patients (40.9%), respectively. Preoperative elevated CRP was present in 8 (9.1%) patients. After a median follow-up duration of 44 months, the cumulative 5-year survival was 45.4% and the median overall survival (OS) was 57.8 months. A significantly longer survival was observed in patients with normal preoperative CRP level compared with those with CRP level exceeding 10mg/L (62.6 months vs. 34.3 months, P=0.011). In multivariate analysis, preoperative CRP level was found to be independent significant prognostic factors for survival.
Pulmonary resection of metastatic colorectal cancer might offer a chance to prolong survival including those patients with extrapulmonary metastasis. Preoperative serum CRP level was identified as prognosis-related factor for surgery.
高达25%的结直肠癌（CRC）患者会发生肺转移。许多研究报告称，肺转移瘤切除术可能会提高这些患者的5年生存率。本研究的目的是描述我们对转移性结直肠癌进行肺转移瘤切除术的经验，并探讨血清C反应蛋白（CRP）及其他因素的预后价值。
回顾性分析2002年6月至2013年12月期间88例行结直肠癌肺转移瘤切除术患者的临床病理资料。前瞻性收集临床、检查及手术数据。总生存期（OS）从肺转移瘤切除至死亡计算。
本研究中有58名男性和30名女性，中位年龄为55岁（范围31至85岁）。59例（78%）患者行电视辅助胸腔镜手术（VATS），29例（19%）患者行开胸手术。分别有52例（59.1%）和36例（40.9%）患者行肺楔形切除术和肺叶切除术。8例（9.1%）患者术前CRP升高。中位随访44个月后，5年累积生存率为45.4%，中位总生存期（OS）为57.8个月。术前CRP水平正常的患者与CRP水平超过10mg/L的患者相比，生存期明显更长（62.6个月对34.3个月，P=0.011）。多因素分析发现，术前CRP水平是生存的独立显著预后因素。
转移性结直肠癌的肺切除术可能为延长生存期提供机会，包括那些有肺外转移的患者。术前血清CRP水平被确定为手术的预后相关因素。
