Heterogeneity of Tumor Sizes in Multiple Pulmonary Metastases of Colorectal Cancer as a Prognostic Factor

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

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The number of metastatic lesions is closely correlated with prognosis in most cancers. The aim of this study was to clarify the relationship between individual heterogeneity of metastatic tumor sizes and prognosis in patients with multiple pulmonary metastasis of colorectal cancer who received surgical treatment. Methods Clinical data for patients who had pulmonary metastasis from colorectal cancer and underwent curative resection at 46 Japanese institutions between January 2004 and December 2008 were collected. Among 898 patients eligible considering these inclusion criteria, 247 patients had multiple metastases and were analyzed. A difference between the maximum and minimum tumor diameters (Dmax-min) on pathologic findings was used to evaluate size heterogeneity. Results The overall survival rate was 75% at 3 years and 58% at 5 years, with a median follow-up period of 65 months (range, 0 to 112). When Dmax-min of 5 mm was set as a cutoff value, overall survival was significantly different between small (≤5 mm, n = 95) and large (>5 mm, n = 152) tumor groups (5-year survival rates, 66.5% and 53.3%, respectively; log rank test, p = 0.025). Multivariate analysis using a Cox proportional hazards model revealed that disease-free interval from resection of primary lesion, serum carcinoembryonic antigen level, number of pulmonary metastases, and Dmax-min were independent prognostic factors. Conclusions The heterogeneity of metastatic tumor sizes may be an indicator for prognosis in patients with multiple pulmonary metastases of colorectal cancer who underwent resection.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalAnnals of Thoracic Surgery
Volume103
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1
Externally publishedYes

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Colorectal Neoplasms
Neoplasm Metastasis
Lung
Neoplasms
Survival Rate
Carcinoembryonic Antigen
Proportional Hazards Models
Multivariate Analysis
Survival
Serum
Therapeutics

ASJC Scopus subject areas

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

Cite this

Heterogeneity of Tumor Sizes in Multiple Pulmonary Metastases of Colorectal Cancer as a Prognostic Factor. / Maniwa, Tomohiro; Mori, Keita; Ohde, Yasuhisa; Okumura, Takehiro; Boku, Narikazu; Hishida, Tomoyuki; Sakao, Yukinori; Yoshiya, Katsuo; Hyodo, Ichinosuke; Kondo, Haruhiko.

In: Annals of Thoracic Surgery, Vol. 103, No. 1, 01.01.2017, p. 254-260.

Research output: Contribution to journalArticle

Maniwa, T, Mori, K, Ohde, Y, Okumura, T, Boku, N, Hishida, T, Sakao, Y, Yoshiya, K, Hyodo, I & Kondo, H 2017, 'Heterogeneity of Tumor Sizes in Multiple Pulmonary Metastases of Colorectal Cancer as a Prognostic Factor', Annals of Thoracic Surgery, vol. 103, no. 1, pp. 254-260. https://doi.org/10.1016/j.athoracsur.2016.07.070
Maniwa, Tomohiro ; Mori, Keita ; Ohde, Yasuhisa ; Okumura, Takehiro ; Boku, Narikazu ; Hishida, Tomoyuki ; Sakao, Yukinori ; Yoshiya, Katsuo ; Hyodo, Ichinosuke ; Kondo, Haruhiko. / Heterogeneity of Tumor Sizes in Multiple Pulmonary Metastases of Colorectal Cancer as a Prognostic Factor. In: Annals of Thoracic Surgery. 2017 ; Vol. 103, No. 1. pp. 254-260.
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AU - Maniwa, Tomohiro

AU - Mori, Keita

AU - Ohde, Yasuhisa

AU - Okumura, Takehiro

AU - Boku, Narikazu

AU - Hishida, Tomoyuki

AU - Sakao, Yukinori

AU - Yoshiya, Katsuo

AU - Hyodo, Ichinosuke

AU - Kondo, Haruhiko

PY - 2017/1/1

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N2 - Background The number of metastatic lesions is closely correlated with prognosis in most cancers. The aim of this study was to clarify the relationship between individual heterogeneity of metastatic tumor sizes and prognosis in patients with multiple pulmonary metastasis of colorectal cancer who received surgical treatment. Methods Clinical data for patients who had pulmonary metastasis from colorectal cancer and underwent curative resection at 46 Japanese institutions between January 2004 and December 2008 were collected. Among 898 patients eligible considering these inclusion criteria, 247 patients had multiple metastases and were analyzed. A difference between the maximum and minimum tumor diameters (Dmax-min) on pathologic findings was used to evaluate size heterogeneity. Results The overall survival rate was 75% at 3 years and 58% at 5 years, with a median follow-up period of 65 months (range, 0 to 112). When Dmax-min of 5 mm was set as a cutoff value, overall survival was significantly different between small (≤5 mm, n = 95) and large (>5 mm, n = 152) tumor groups (5-year survival rates, 66.5% and 53.3%, respectively; log rank test, p = 0.025). Multivariate analysis using a Cox proportional hazards model revealed that disease-free interval from resection of primary lesion, serum carcinoembryonic antigen level, number of pulmonary metastases, and Dmax-min were independent prognostic factors. Conclusions The heterogeneity of metastatic tumor sizes may be an indicator for prognosis in patients with multiple pulmonary metastases of colorectal cancer who underwent resection.

AB - Background The number of metastatic lesions is closely correlated with prognosis in most cancers. The aim of this study was to clarify the relationship between individual heterogeneity of metastatic tumor sizes and prognosis in patients with multiple pulmonary metastasis of colorectal cancer who received surgical treatment. Methods Clinical data for patients who had pulmonary metastasis from colorectal cancer and underwent curative resection at 46 Japanese institutions between January 2004 and December 2008 were collected. Among 898 patients eligible considering these inclusion criteria, 247 patients had multiple metastases and were analyzed. A difference between the maximum and minimum tumor diameters (Dmax-min) on pathologic findings was used to evaluate size heterogeneity. Results The overall survival rate was 75% at 3 years and 58% at 5 years, with a median follow-up period of 65 months (range, 0 to 112). When Dmax-min of 5 mm was set as a cutoff value, overall survival was significantly different between small (≤5 mm, n = 95) and large (>5 mm, n = 152) tumor groups (5-year survival rates, 66.5% and 53.3%, respectively; log rank test, p = 0.025). Multivariate analysis using a Cox proportional hazards model revealed that disease-free interval from resection of primary lesion, serum carcinoembryonic antigen level, number of pulmonary metastases, and Dmax-min were independent prognostic factors. Conclusions The heterogeneity of metastatic tumor sizes may be an indicator for prognosis in patients with multiple pulmonary metastases of colorectal cancer who underwent resection.

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