PULMONARY RESECTION FOR METASTASES OF COLORECTAL ORIGIN

Study objective: To develop selection criteria for pulmonary metastasectomy in patients with metastases of colorectal cancer confined to the lungs. Design: A retrospective study. Setting: Medical records of all patients operated on for this condition in the Netherlands in the period 1982 to 1992 (n=38). Intervention: Evaluation by means of Cox's proportional hazards regression analysis of factors, which might relate to postthoracotomy disease-free survival and/or postthoracotomy survival. Measurements and results: The 5-year disease-free survival was 31%, and the overall 5-year survival was 43% (Kaplan-Meyer). Multivariately, a number of three or fewer metastases (p=0.012) and a short delay between detection of pulmonary metastases and resection (p=0.05) related to a longer postthoracotomy disease-free interval. A longer interval between resection of the primary tumor and detection of lung metastases related to a longer postthoracotomy survival (p=0.021). Conclusions: Patients with three or less pulmonary metastases of colorectal origin may benefit from resection; once metastases have been detected, resection should not be postponed.