Prognostic Factors of Pulmonary Metastasectomy for Colorectal Carcinomas

Pulmonary metastasectomy for colorectal carcinoma is a well-accepted procedure; however, reports on indications and prognostic factors are inconsistent. This study was designed to clarify a role for resection of pulmonary metastases for such tumors and to define the patients who benefit from pulmonary metastasectomy. Between 1990 and 2007, 84 patients with pulmonary metastases from colorectal carcinomas underwent curative pulmonary resection. All patients had obtained or had obtainable locoregional control of their primary tumors. Various perioperative variables were investigated retrospectively to confirm a role for metastasectomy and to analyze prognostic factors for overall survival and disease-free survival after metastasectomy. Overall survival rate after metastasectomy was 60.5% and 48.4% at 5 and 10 years, respectively. Disease-free survival rate was 34.4% and 30.6% at 5 and 10 years after pulmonary resection, respectively. On multivariate analysis, patients with unilateral pulmonary metastasis presented a significantly favorable overall survival (P = 0.045). In contrast, there was no significant prognostic factor for disease-free survival. Current practice of pulmonary metastasectomy for colorectal carcinoma in our institution was well justified. Our study confirmed that unilateral pulmonary metastasis was significantly relevant to a better prognosis.