TY - JOUR
T1 - Surgery for lung metastases from colorectal cancer
T2 - Analysis of prognostic factors
AU - Girard, P.
AU - Ducreux, M.
AU - Baldeyrou, P.
AU - Rougier, P.
AU - Le Chevalier, T.
AU - Bougaran, J.
AU - Lasser, P.
AU - Gayet, B.
AU - Ruffié, P.
AU - Grunenwald, D.
PY - 1996/1/1
Y1 - 1996/1/1
N2 - Purpose: To identify prognostic factors of improved survival after resection of isolated pulmonary metastases (PM) from colorectal cancer. Patients and Methods: A retrospective analysis of the records of all patients with PM from colorectal cancer who underwent thoracic surgery with curative intent before December 1992 at a single surgical center was performed. Univariate (log-rank) and multivariate (Cox's model) analyses of survival were used to identify significant prognostic factors. Results: Eighty-six patients with PM from colon (n = 49) or rectal (n = 37) cancer underwent 102 thoracic operations, which included 21 bilateral and 10 incomplete resections. The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 24% (95% confidence interval [CI], 15% to 35%) and 20% (95% CI, 13% to 31%), respectively. Sex, age, site of the primary tumor (colon or rectum), disease-free interval (DFI), and previous resection of hepatic metastases were found not to be statistically significant prognostic factors. Complete rejection, a limited number (< two) of PM, and a normal prethoracotomy serum carcinoembryonic antigen (CEA) level were predictors of a longer survival duration by univariate analysis, but only complete resection (P = .024) and preoperative CEA level (P = .001) were identified as independent prognostic factors by multivariate analysis. The estimated 5-year survival rate of patients with a normal prethoracotomy CEA level was 60%, as compared with 4% in cases with elevated (> 5 ng/mL) CEA level. Conclusion: Besides resectability, the prethoracotomy serum CEA level appears the most reliable predictor of survival in patients with isolated PM from colorectal cancer.
AB - Purpose: To identify prognostic factors of improved survival after resection of isolated pulmonary metastases (PM) from colorectal cancer. Patients and Methods: A retrospective analysis of the records of all patients with PM from colorectal cancer who underwent thoracic surgery with curative intent before December 1992 at a single surgical center was performed. Univariate (log-rank) and multivariate (Cox's model) analyses of survival were used to identify significant prognostic factors. Results: Eighty-six patients with PM from colon (n = 49) or rectal (n = 37) cancer underwent 102 thoracic operations, which included 21 bilateral and 10 incomplete resections. The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 24% (95% confidence interval [CI], 15% to 35%) and 20% (95% CI, 13% to 31%), respectively. Sex, age, site of the primary tumor (colon or rectum), disease-free interval (DFI), and previous resection of hepatic metastases were found not to be statistically significant prognostic factors. Complete rejection, a limited number (< two) of PM, and a normal prethoracotomy serum carcinoembryonic antigen (CEA) level were predictors of a longer survival duration by univariate analysis, but only complete resection (P = .024) and preoperative CEA level (P = .001) were identified as independent prognostic factors by multivariate analysis. The estimated 5-year survival rate of patients with a normal prethoracotomy CEA level was 60%, as compared with 4% in cases with elevated (> 5 ng/mL) CEA level. Conclusion: Besides resectability, the prethoracotomy serum CEA level appears the most reliable predictor of survival in patients with isolated PM from colorectal cancer.
UR - http://www.scopus.com/inward/record.url?scp=8944222568&partnerID=8YFLogxK
U2 - 10.1200/JCO.1996.14.7.2047
DO - 10.1200/JCO.1996.14.7.2047
M3 - Article
AN - SCOPUS:8944222568
SN - 0732-183X
VL - 14
SP - 2047
EP - 2053
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 7
ER -