Surgical treatment for patients with pulmonary metastases after resection of primary colorectal carcinoma

Cancer. 1995 Aug 1;76(3):393-8. doi: 10.1002/1097-0142(19950801)76:3<393::aid-cncr2820760308>;2-8.


Background: The optimum treatment for patients with pulmonary metastases from colorectal carcinoma is still controversial.

Methods: To evaluate the results of pulmonary resection in 22 patients with pulmonary metastases after resection of primary colorectal carcinoma, patients' characteristics were examined retrospectively. Eighteen patients had a solitary metastatic lesion and four had two lesions.

Results: Postthoracotomy recurrence occurred in 17 of the 22 patients (77.3%), and showed no correlation with the type of pulmonary resection. In 11 patients with a solitary lesion of less than 3.0 cm in greatest dimension, the 3- and 5-year postthoracotomy survival rates (PTSR) were 71.6% and 36.8%, respectively. Six of these patients received two or more thoracotomies for pulmonary recurrence. The 3-year PTSR for seven patients with a solitary lesion greater than or equal to 3.0 cm was 19.0%, and for the four patients with two lesions, 25.0%. A significant difference was noted in the survival rate according to both number and size of the metastatic lesions (P < 0.05).

Conclusions: The number and size of metastatic lesions appear to be important prognostic determinants. Repeated thoracotomy can prolong survival for selected patients.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pneumonectomy
  • Prognosis
  • Reoperation
  • Retrospective Studies
  • Survival Rate
  • Thoracotomy