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切除边缘长度和肿瘤深度对单发性结直肠癌肺转移灶胸腔镜肺楔形切除术后局部复发的影响。

Impact of resection margin length and tumor depth on the local recurrence after thoracoscopic pulmonary wedge resection of a single colorectal metastasis.

作者信息

Chung Jae Ho, Lee Sung Ho, Yi Eunjue, Lim Ju Yong, Jung Jae Seung, Son Ho Sung, Sun Kyung

机构信息

Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Anam Hospital, Seoul, South Korea.

出版信息

J Thorac Dis. 2019 May;11(5):1879-1887. doi: 10.21037/jtd.2019.05.12.


DOI:10.21037/jtd.2019.05.12
PMID:31285880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6588790/
Abstract

BACKGROUND: To evaluate the influence of tumor depth on preoperative computed tomography (CT) image, and resection margin length on local recurrence after pulmonary metastasectomy of colorectal cancer. METHODS: Patients undergoing thoracoscopic pulmonary wedge resection for single pulmonary metastasis of colorectal cancer origin from 2007 to 2017 were analyzed. Factors such as resection margin, tumor size and depth were analyzed. The local recurrences of two subgroups based on the pulmonary resection margin (Group 1: resection margin 1-10 mm or shorter than the tumor size, Group 2: resection margin >10 mm or at least greater than the tumor size) were analyzed. RESULTS: Sixty-five patients were included in this study. The local recurrence rate was 12/65 (18.5%). Median follow up period was 33 months. Median tumor size and depth on preoperative CT were 1.1 and 1.6 cm. Median length of resection margin was 0.5 cm (group 1: 0.4 cm, group 2: 1.0 cm, P<0.001). No difference was noted in 3-year local recurrence-free survival (80.8% 76.7%, P=0.756) between the two subgroups. No significant correlation was noted between the length of resection margin and the tumor size and depth. However, tumor depth was an independent factor related to higher local recurrence on multivariate analysis. CONCLUSIONS: Extent of resection margin in pulmonary metastasectomy does not seem to affect significantly on the local recurrence if complete resection is accomplished. However, preoperative tumor depth on CT image and postoperative distant metastasis seem to affect on local recurrence after pulmonary metastasectomy.

摘要

背景:评估肿瘤深度对术前计算机断层扫描(CT)图像的影响,以及结直肠癌肺转移瘤切除术后切缘长度对局部复发的影响。 方法:分析2007年至2017年因结直肠癌单发肺转移接受胸腔镜肺楔形切除术的患者。分析切缘、肿瘤大小和深度等因素。对基于肺切除切缘的两个亚组(第1组:切缘1 - 10毫米或短于肿瘤大小,第2组:切缘>10毫米或至少大于肿瘤大小)的局部复发情况进行分析。 结果:本研究纳入65例患者。局部复发率为12/65(18.5%)。中位随访期为33个月。术前CT上肿瘤大小和深度的中位数分别为1.1厘米和1.6厘米。切缘长度的中位数为0.5厘米(第1组:0.4厘米,第2组:1.0厘米,P<0.001)。两个亚组之间的3年无局部复发生存率无差异(80.8%对76.7%,P = 0.756)。切缘长度与肿瘤大小和深度之间未发现显著相关性。然而,在多因素分析中,肿瘤深度是与较高局部复发相关的独立因素。 结论:如果实现了完整切除,肺转移瘤切除术中切缘范围似乎对局部复发没有显著影响。然而,术前CT图像上的肿瘤深度和术后远处转移似乎对肺转移瘤切除术后的局部复发有影响。

相似文献

[1]
Impact of resection margin length and tumor depth on the local recurrence after thoracoscopic pulmonary wedge resection of a single colorectal metastasis.

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[7]
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Cancers (Basel). 2025-2-18

[2]
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[3]
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[4]
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[5]
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本文引用的文献

[1]
Pulmonary metastasectomy: a cross sectional survey.

J Thorac Dis. 2018-6

[2]
Pulmonary Metastasectomy for Colorectal Cancer: Predictors of Survival in Routine Surgical Practice.

Ann Thorac Surg. 2018-3-5

[3]
Growth patterns of pulmonary metastases: should we adjust resection techniques to primary histology and size?

Eur J Cardiothorac Surg. 2017-7-1

[4]
Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer.

Eur J Cardiothorac Surg. 2017-3-1

[5]
Sublobar Resection Margin Width Does Not Affect Recurrence of Clinical N0 Non-small Cell Lung Cancer Presenting as GGO-Predominant Nodule of 3 cm or Less.

World J Surg. 2017-2

[6]
Are there recognized prognostic factors for patients undergoing pulmonary metastasectomy for colorectal carcinoma?

Interact Cardiovasc Thorac Surg. 2016-12

[7]
Role of major resection in pulmonary metastasectomy for colorectal cancer in the Spanish prospective multicenter study (GECMP-CCR).

Ann Oncol. 2016-2-18

[8]
Results of Pulmonary Resection: Colorectal Carcinoma.

Thorac Surg Clin. 2016-2

[9]
The prognostic importance of the number of metastases in pulmonary metastasectomy of colorectal cancer.

World J Surg Oncol. 2015-7-25

[10]
Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection.

Gen Thorac Cardiovasc Surg. 2015-6

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