Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study

Tomoyuki Hishida, Masahiro Tsuboi, Takehiro Okumura, Narikazu Boku, Yasuhisa Ohde, Yukinori Sakao, Katsuo Yoshiya, Ichinosuke Hyodo, Keita Mori, Haruhiko Kondo

Research output: Contribution to journalArticle

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Abstract

Background The purpose of this study was to clarify the long-term survival outcomes after repeated lung resection (RLR) of pulmonary metastases from colorectal cancer (PM-CRC) using data from a Japanese nationwide investigation. Methods Among 898 patients who underwent R0 resection of PM-CRC at 46 Japanese institutions between 2004 and 2008, we analyzed the data of 216 patients who experienced recurrence limited to the lung after initial resection of PM-CRC. Overall survival (OS) after RLR was analyzed, and prognostic factors were explored using a multivariate Cox analysis. Results Of a total 216 patients, 132 (61%) received RLR, and their 5-year OS rate was 75.3%. Twenty-two patients underwent a second RLR, and 2 patients underwent a third RLR; a favorable survival outcome was observed even after a second RLR (5-year OS rate, 55.1%). The prognostic factors associated with worse survival after RLR were concomitant liver metastasis, which had been completely resected or ablated at the initial lung metastasectomy (hazard ratio [HR], 4.84; 95% confidence interval [CI], 1.48–14.8) and location of the primary tumor in the rectum (HR, 3.16; 95% CI, 1.17–9.35). Patients without these 2 poor prognostic factors (n = 58) showed a 5-year OS rate of 82.6% after RLR. Conclusions This nationwide database study showed that RLR for resectable lung-limited recurrence after PM-CRC resection could provide favorable survival, especially for patients with colon cancer without liver metastases at the initial PM-CRC resection.

Original languageEnglish
Pages (from-to)399-405
Number of pages7
JournalAnnals of Thoracic Surgery
Volume103
Issue number2
DOIs
Publication statusPublished - 2017 Feb 1
Externally publishedYes

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Colorectal Neoplasms
Retrospective Studies
Neoplasm Metastasis
Lung
Survival
Survival Rate
Metastasectomy
Confidence Intervals
Recurrence
Liver Neoplasms
Rectum
Colonic Neoplasms
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study. / Hishida, Tomoyuki; Tsuboi, Masahiro; Okumura, Takehiro; Boku, Narikazu; Ohde, Yasuhisa; Sakao, Yukinori; Yoshiya, Katsuo; Hyodo, Ichinosuke; Mori, Keita; Kondo, Haruhiko.

In: Annals of Thoracic Surgery, Vol. 103, No. 2, 01.02.2017, p. 399-405.

Research output: Contribution to journalArticle

Hishida, Tomoyuki ; Tsuboi, Masahiro ; Okumura, Takehiro ; Boku, Narikazu ; Ohde, Yasuhisa ; Sakao, Yukinori ; Yoshiya, Katsuo ; Hyodo, Ichinosuke ; Mori, Keita ; Kondo, Haruhiko. / Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study. In: Annals of Thoracic Surgery. 2017 ; Vol. 103, No. 2. pp. 399-405.
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abstract = "Background The purpose of this study was to clarify the long-term survival outcomes after repeated lung resection (RLR) of pulmonary metastases from colorectal cancer (PM-CRC) using data from a Japanese nationwide investigation. Methods Among 898 patients who underwent R0 resection of PM-CRC at 46 Japanese institutions between 2004 and 2008, we analyzed the data of 216 patients who experienced recurrence limited to the lung after initial resection of PM-CRC. Overall survival (OS) after RLR was analyzed, and prognostic factors were explored using a multivariate Cox analysis. Results Of a total 216 patients, 132 (61{\%}) received RLR, and their 5-year OS rate was 75.3{\%}. Twenty-two patients underwent a second RLR, and 2 patients underwent a third RLR; a favorable survival outcome was observed even after a second RLR (5-year OS rate, 55.1{\%}). The prognostic factors associated with worse survival after RLR were concomitant liver metastasis, which had been completely resected or ablated at the initial lung metastasectomy (hazard ratio [HR], 4.84; 95{\%} confidence interval [CI], 1.48–14.8) and location of the primary tumor in the rectum (HR, 3.16; 95{\%} CI, 1.17–9.35). Patients without these 2 poor prognostic factors (n = 58) showed a 5-year OS rate of 82.6{\%} after RLR. Conclusions This nationwide database study showed that RLR for resectable lung-limited recurrence after PM-CRC resection could provide favorable survival, especially for patients with colon cancer without liver metastases at the initial PM-CRC resection.",
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T1 - Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study

AU - Hishida, Tomoyuki

AU - Tsuboi, Masahiro

AU - Okumura, Takehiro

AU - Boku, Narikazu

AU - Ohde, Yasuhisa

AU - Sakao, Yukinori

AU - Yoshiya, Katsuo

AU - Hyodo, Ichinosuke

AU - Mori, Keita

AU - Kondo, Haruhiko

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background The purpose of this study was to clarify the long-term survival outcomes after repeated lung resection (RLR) of pulmonary metastases from colorectal cancer (PM-CRC) using data from a Japanese nationwide investigation. Methods Among 898 patients who underwent R0 resection of PM-CRC at 46 Japanese institutions between 2004 and 2008, we analyzed the data of 216 patients who experienced recurrence limited to the lung after initial resection of PM-CRC. Overall survival (OS) after RLR was analyzed, and prognostic factors were explored using a multivariate Cox analysis. Results Of a total 216 patients, 132 (61%) received RLR, and their 5-year OS rate was 75.3%. Twenty-two patients underwent a second RLR, and 2 patients underwent a third RLR; a favorable survival outcome was observed even after a second RLR (5-year OS rate, 55.1%). The prognostic factors associated with worse survival after RLR were concomitant liver metastasis, which had been completely resected or ablated at the initial lung metastasectomy (hazard ratio [HR], 4.84; 95% confidence interval [CI], 1.48–14.8) and location of the primary tumor in the rectum (HR, 3.16; 95% CI, 1.17–9.35). Patients without these 2 poor prognostic factors (n = 58) showed a 5-year OS rate of 82.6% after RLR. Conclusions This nationwide database study showed that RLR for resectable lung-limited recurrence after PM-CRC resection could provide favorable survival, especially for patients with colon cancer without liver metastases at the initial PM-CRC resection.

AB - Background The purpose of this study was to clarify the long-term survival outcomes after repeated lung resection (RLR) of pulmonary metastases from colorectal cancer (PM-CRC) using data from a Japanese nationwide investigation. Methods Among 898 patients who underwent R0 resection of PM-CRC at 46 Japanese institutions between 2004 and 2008, we analyzed the data of 216 patients who experienced recurrence limited to the lung after initial resection of PM-CRC. Overall survival (OS) after RLR was analyzed, and prognostic factors were explored using a multivariate Cox analysis. Results Of a total 216 patients, 132 (61%) received RLR, and their 5-year OS rate was 75.3%. Twenty-two patients underwent a second RLR, and 2 patients underwent a third RLR; a favorable survival outcome was observed even after a second RLR (5-year OS rate, 55.1%). The prognostic factors associated with worse survival after RLR were concomitant liver metastasis, which had been completely resected or ablated at the initial lung metastasectomy (hazard ratio [HR], 4.84; 95% confidence interval [CI], 1.48–14.8) and location of the primary tumor in the rectum (HR, 3.16; 95% CI, 1.17–9.35). Patients without these 2 poor prognostic factors (n = 58) showed a 5-year OS rate of 82.6% after RLR. Conclusions This nationwide database study showed that RLR for resectable lung-limited recurrence after PM-CRC resection could provide favorable survival, especially for patients with colon cancer without liver metastases at the initial PM-CRC resection.

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