Universität zu Köln

Macherey, Sascha, Bruns, Christiane, Alakus, Hakan, Doerr, Fabian, Heldwein, Matthias, Quaas, Alexander, Wahlers, Thorsten and Hekmat, Khosro (2018). Lung Metastasectomy in Pulmonary Metastatic Colorectal Carcinoma. Zent.bl. Chir., 143 (2). S. 193 - 204. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9592

Full text not available from this repository.

Abstract

Background Patients with colorectal cancer are often affected by liver and lung metastases. Besides systemic therapies, lung metastasectomy is a suitable treatment option after complete resection of primary colorectal carcinoma and even concomitant liver metastases. Material and Methods We have performed a systematical literature research of all studies published after 01.01.2010. Studies reporting on at least 100 patients undergoing lung metastasectomy after 01.01.2000 have been included in our final analysis. Operative data, survival data and prognostic factors have been extracted. Results Eleven study cohorts reporting on 2,891 patients could be included in the final analysis. Complete resection could be achieved in most cases and thoracic surgeons preferred subsegmental resections. Pathological examination revealed thoracic lymph node involvement in 2.3 to 18.2% of patients. The postoperative mortality varied from 0 to 0.5%. The median follow up ranged between 27.5 and 65.1 months. Pulmonary metastasectomy resulted in 5-year survival rates of 53 to 75.5% and 5-year progression-free survival rates of 33 to 50.9%. Intrathoracic recurrence occurred in 25.2 to 42.9% of patients with complete resection and five-year survival rates ranged from 49 to 75.5% after repeat pulmonary metastasectomy. Analysis of prognostic factors revealed that number, size and distribution of lung metastases are minor important prognostic factors. Moreover, current data suggest disadvantageous post-metastasectomy survival for patients with elevated pre-metastasectomy serum CEA level or intrathoracic lymph node metastases in comparison with the control groups. Nevertheless, even in these patients, lung metastasectomy might be a beneficial procedure. Conclusions In patients with colorectal cancer and resectable isolated lung or combined liver and lung metastases pulmonary resection should be the treatment of choice. Pulmonary metastasectomy should be combined with thoracic lymph node resection to remove potential lymph node metastases. Repeat metastasectomy should be offered to patients suffering from isolated intrathoracic recurrence.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Macherey, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Doerr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldwein, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Quaas, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-190664
DOI:	10.1055/s-0043-114734
Journal or Publication Title:	Zent.bl. Chir.
Volume:	143
Number:	2
Page Range:	S. 193 - 204
Date:	2018
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9592
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROSPECTIVE MULTICENTER; GECMP-CCR; CANCER; SURVIVAL; RESECTION; RECURRENCE; SPANISH Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19066