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Treatment and survival of patients with metachronous colorectal lung metastases

Hansdotter, Pernilla LU ; Scherman, Peter LU ; Nikberg, Maziar ; Petersen, Sune H. ; Holmberg, Erik ; Rizell, Magnus ; Naredi, Peter LU and Syk, Ingvar LU (2023) In Journal of Surgical Oncology 127(5). p.806-814
Abstract

Introduction: The lungs are the second most common site for metachronous metastases in colorectal cancer. No treatment algorithm is established, and the role of adjuvant chemotherapy is unclear. This study aimed to map pulmonary recurrences in a modern multimodal treated population, and to evaluate survival depending on management. Methods: Retrospective study based on the COLOFOL-trial population of 2442 patients, radically resected for colorectal cancer stage II–III. All recurrences within 5 years were identified and medical records were scrutinized. Results: Of 165 (6.8%) patients developing lung metastases as first recurrence, 89 (54%) were confined to the lungs. Potentially curative treatment was possible in 62 (37%) cases, of... (More)

Introduction: The lungs are the second most common site for metachronous metastases in colorectal cancer. No treatment algorithm is established, and the role of adjuvant chemotherapy is unclear. This study aimed to map pulmonary recurrences in a modern multimodal treated population, and to evaluate survival depending on management. Methods: Retrospective study based on the COLOFOL-trial population of 2442 patients, radically resected for colorectal cancer stage II–III. All recurrences within 5 years were identified and medical records were scrutinized. Results: Of 165 (6.8%) patients developing lung metastases as first recurrence, 89 (54%) were confined to the lungs. Potentially curative treatment was possible in 62 (37%) cases, of which 33 with surgery only and 29 with surgery and chemotherapy combined. The 5-year overall survival (5-year OS) for all lung recurrences was 28%. In patients treated with chemotherapy only the 5-year OS was 7.5%, compared with 55% in patients treated with surgery, and 72% when surgery was combined with chemotherapy. Hazard ratio for mortality was 2.9 (95% confidence interval 1.40–6.10) for chemotherapy only compared to surgery. Conclusion: A high proportion of metachronous lung metastases after colorectal surgery were possible to resect, yielding good survival. The combination of surgery and chemotherapy might be advantageous for survival.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
follow-up, lung recurrence, prognosis, risk factors
in
Journal of Surgical Oncology
volume
127
issue
5
pages
806 - 814
publisher
Wiley-Blackwell
external identifiers
  • pmid:36607235
  • scopus:85145741434
ISSN
0022-4790
DOI
10.1002/jso.27188
language
English
LU publication?
yes
id
b5c93ac7-18ad-4d76-8c10-46643b4e2582
date added to LUP
2023-02-21 10:09:47
date last changed
2024-07-11 19:29:52
@article{b5c93ac7-18ad-4d76-8c10-46643b4e2582,
  abstract     = {{<p>Introduction: The lungs are the second most common site for metachronous metastases in colorectal cancer. No treatment algorithm is established, and the role of adjuvant chemotherapy is unclear. This study aimed to map pulmonary recurrences in a modern multimodal treated population, and to evaluate survival depending on management. Methods: Retrospective study based on the COLOFOL-trial population of 2442 patients, radically resected for colorectal cancer stage II–III. All recurrences within 5 years were identified and medical records were scrutinized. Results: Of 165 (6.8%) patients developing lung metastases as first recurrence, 89 (54%) were confined to the lungs. Potentially curative treatment was possible in 62 (37%) cases, of which 33 with surgery only and 29 with surgery and chemotherapy combined. The 5-year overall survival (5-year OS) for all lung recurrences was 28%. In patients treated with chemotherapy only the 5-year OS was 7.5%, compared with 55% in patients treated with surgery, and 72% when surgery was combined with chemotherapy. Hazard ratio for mortality was 2.9 (95% confidence interval 1.40–6.10) for chemotherapy only compared to surgery. Conclusion: A high proportion of metachronous lung metastases after colorectal surgery were possible to resect, yielding good survival. The combination of surgery and chemotherapy might be advantageous for survival.</p>}},
  author       = {{Hansdotter, Pernilla and Scherman, Peter and Nikberg, Maziar and Petersen, Sune H. and Holmberg, Erik and Rizell, Magnus and Naredi, Peter and Syk, Ingvar}},
  issn         = {{0022-4790}},
  keywords     = {{follow-up; lung recurrence; prognosis; risk factors}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{806--814}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Surgical Oncology}},
  title        = {{Treatment and survival of patients with metachronous colorectal lung metastases}},
  url          = {{http://dx.doi.org/10.1002/jso.27188}},
  doi          = {{10.1002/jso.27188}},
  volume       = {{127}},
  year         = {{2023}},
}