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

Abstract

The optimum treatment for patients with pulmonary metastases from colorectal carcinoma is still controversial. 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. 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). The number and size of metastatic lesions appear to be important prognostic determinants. Repeated thoracotomy can prolong survival for selected patients.