Department of Digestive and Oncologic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, 9 Avenue Charles de Gaulle, 92104, Boulogne-Billancourt, France.
Department of Thoracic Surgery and Lung Transplantation, Foch Hospital, Suresnes, France.
J Gastrointest Cancer. 2023 Dec;54(4):1185-1192. doi: 10.1007/s12029-022-00908-x. Epub 2023 Jan 3.
Treatment of pulmonary metastases (PM) from colorectal cancer (CRC) is the standard of care by several guidelines from Europe and the USA, but the validity of this strategy has been recently questioned, and the available evidence supporting this strategy is weak. We report the outcomes of a curative intent strategy in a very recent and homogenous series of patients.
We did a retrospective review of all curative intent surgical or ablative treatment of PM from CRC performed consecutively in 3 French institutions from January 2015 to December 2019. Demographics, clinicopathological, and molecular characteristics were evaluated. Cox regression models were used to identify prognostic factors related to local recurrence and disease-free survival.
Records from 152 patients were reviewed. One-hundred thirty-five patients (88%) had surgical metastasectomy. Median age was 67 years. Most of the patients had a single lesion (66%), and 16% had synchronous PM. Eighty-one patients (53%) experienced recurrence, and the thorax was the most common site of recurrence. Median disease-free survival and overall survival were 35 months and 78 months after PM treatment. At the end of the study, only 17% of the patients died. Pulmonary tumor burden was correlated with disease-free survival in univariate analysis, but multivariate analysis did not find any prognostic factor independently associated with local recurrence or survival.
Our finds corroborate existing recommendation for the invasive treatment of PM from CRC in selected patients.
欧洲和美国的多项指南均推荐对结直肠癌（CRC）肺转移（PM）进行治疗，但最近对该策略的有效性提出了质疑，并且支持该策略的证据有限。我们报告了最近一系列同质患者中采用治愈性意图策略的结果。
我们对 2015 年 1 月至 2019 年 12 月在法国 3 家机构连续进行的 CRC 肺 PM 的所有治愈性意图手术或消融治疗的患者进行了回顾性研究。评估了人口统计学、临床病理和分子特征。Cox 回归模型用于确定与局部复发和无病生存相关的预后因素。
回顾了 152 例患者的记录。135 例（88%）患者行手术转移切除术。中位年龄为 67 岁。大多数患者有单个病变（66%），16%有同步 PM。81 例（53%）患者出现复发，胸部是最常见的复发部位。PM 治疗后，无病生存和总生存中位数分别为 35 个月和 78 个月。在研究结束时，只有 17%的患者死亡。单因素分析显示肺肿瘤负荷与无病生存相关，但多因素分析未发现任何与局部复发或生存相关的独立预后因素。
我们的发现支持了对特定患者的 CRC 肺 PM 进行侵袭性治疗的现有建议。
