Zurlo Ina Valeria, Calegari Maria Alessandra, Congedo Maria Teresa, Basso Michele, Vita Maria Letizia, Petracca Ciavarella Leonardo, Vivolo Raffaella, Anghelone Annunziato, Pozzo Carmelo, Salvatore Lisa, Meacci Elisa, Margaritora Stefano, Tortora Giampaolo
Oncologia Medica, Fondazione Policlinico Universitario "A Gemelli"-IRCCS, Largo Francesco Vito n 1, 00168 Rome, Italy.
Oncologia Medica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Clin Med. 2024 Nov 6;13(22):6651. doi: 10.3390/jcm13226651.
: Unlike liver metastases, the role of surgery in colorectal cancer lung-limited metastases (CCLLM) is not yet established, and data are still poor. We performed a retrospective analysis to evaluate the impact of surgery on the management of CCLLM. : We retrospectively analyzed patients who received surgery for CCLLM at our Institution from January 2010 to June 2019. The aim of the study was to evaluate the impact of clinical and pathological features on the survival (OS and DFS) of patients treated with surgery for CCLLM. : One hundred and fifty patients were included in the analysis. Seventy-six patients received preoperative chemotherapy (pCT) and 56 an adjuvant treatment (aCT), while 18 underwent up-front surgery without CT. In the whole population, median OS (mOS) and median DFS (mDFS) were 54.1 months (95%CI 44.0-82.1) and 24.0 months (95%CI 20.0-31.2), respectively. In multivariate analysis, number of metastases was the only factor correlated to DFS ( = 0.0006) and OS ( = 0.0018). : Our study, although retrospective and of small size, shows that tumor burden (number of metastases) is the main prognostic factor in patients undergoing lung surgery for CCLLM. Moreover, our results suggest that surgery for lung metastases might prolong survival. These data strengthen the role of multidisciplinary management to allow patients with CCLLM to pursue local treatment whenever possible, even regardless of previous liver surgery or mutated status.
与肝转移不同，手术在结直肠癌肺局限性转移（CCLLM）中的作用尚未确立，相关数据仍然匮乏。我们进行了一项回顾性分析，以评估手术对CCLLM治疗的影响。：我们回顾性分析了2010年1月至2019年6月在我院接受CCLLM手术的患者。本研究的目的是评估临床和病理特征对接受CCLLM手术治疗患者生存（总生存期和无病生存期）的影响。：150例患者纳入分析。76例患者接受了术前化疗（pCT），56例接受了辅助治疗（aCT），而18例患者未接受CT检查直接进行了手术。在整个研究人群中，中位总生存期（mOS）和中位无病生存期（mDFS）分别为54.1个月（95%CI 44.0 - 82.1）和24.0个月（95%CI 20.0 - 31.2）。在多变量分析中，转移灶数量是唯一与DFS（P = 0.0006）和OS（P = 0.0018）相关的因素。：我们的研究虽然是回顾性的且样本量较小，但表明肿瘤负荷（转移灶数量）是接受CCLLM肺手术患者的主要预后因素。此外，我们的结果表明，肺转移灶手术可能会延长生存期。这些数据强化了多学科管理的作用，使CCLLM患者尽可能接受局部治疗，即使不考虑既往肝脏手术或KRAS突变状态。
