Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer

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

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVES: Although wedge resection is the most common surgical procedure for pulmonary metastases from colorectal cancer, there are few reports about segmentectomy for colorectal metastasectomy. METHODS: This was a subset analysis of a Japanese nationwide retrospective study of resected pulmonary metastases from colorectal cancer. The study included 553 patients who underwent segmentectomies (n = 98) or wedge resections (n = 455) without preoperative chemotherapy between January 2004 and December 2008. Recurrence patterns, recurrence-free survival and overall survival were analysed for each procedure. RESULTS: As for the patients' background factors, only the median size of resected metastases was different between patients with segmentectomies (median 18 mm, range 5-50 mm) and wedge resections (14 mm, 5-51 mm) (P < 0.001). Prolonged air leak developed more frequently in those undergoing segmentectomy compared with wedge resection (5.1% vs 1.8%) (P = 0.048). The resection-margin recurrence rate was higher in patients who underwent wedge resection compared with segmentectomy (7.3% vs 2.0%; P = 0.035). The 5-year recurrence-free survival was 48.8% in patients with segmentectomy and 36.0% in patients with wedge resections. The 5-year overall survival was 80.1% in patients with segmentectomy and 68.5% in patients with wedge resection. Multivariable analysis revealed that the surgical procedure, segmentectomy, was a significant favourable factor for recurrence (hazard ratio: 0.63, 95% confidence interval: 0.44-0.87, P = 0.005), but not for overall survival (hazard ratio: 0.65, 95% confidence interval: 0.38-1.05, P = 0.080). CONCLUSIONS: Segmentectomy demonstrated a good efficacy with less resection-margin recurrence in patients with resectable pulmonary-limited metastasis from colorectal cancer.

Original languageEnglish
Pages (from-to)504-510
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume51
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1
Externally publishedYes

Keywords

  • Metastasectomy
  • Segmentectomy
  • Wedge resection

ASJC Scopus subject areas

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

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  • Cite this

    Shiono, S., Okumura, T., Boku, N., Hishida, T., Ohde, Y., Sakao, Y., Yoshiya, K., Hyodo, I., Mori, K., & Kondo, H. (2017). Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer. European Journal of Cardio-thoracic Surgery, 51(3), 504-510. https://doi.org/10.1093/ejcts/ezw322