초록접수 현황
| 16F-246 | 구연 발표 |
Prognostic Effect of Repeated Pulmonary Metastasectomy in Colorectal Cancer Patients with Intrapulmonary Recurrences after Curative Pulmonary Metastasectomy.
Samina Park, In Kyu Park, Kwanyong Hyun, Yoohwa Hwang,
Hyun Joo Lee, Chang Hyun Kang, Young Tae Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Background : Selection bias is a crucial problem hindering objective estimation of effect of pulmonary metastsectomy (PM) in colorectal cancer. We investigated long-term survivals of patients who developed intrapulmonary recurrence after first PM to minimize patient selection bias.
Methods : We reviewed medical records of 226 patients who underwent PM for pulmonary metastasis of colorectal cancer. Among them, 116 (51.3%) patients developed recurrence after first PM (Figure 1a). We analyzed long-term survivals of patients who developed intrapulmonary recurrence after first PM according to receiving second PM.
Results : After first PM, 81 patients had isolated pulmonary recurrence. Median follow duration was 31months. Among them, 46 patients underwent repeated PM and 35 patients were received chemotherapy or close observation. There was no significant difference in age, gender, colorectal cancer stages, surgical procedures, pulmonary metastasis number, laterality, mediastinal node metastasis, and chemotherapy between repeated PM and non-surgical groups (table). There was one operation mortality. Overall 5-year survival rates after first PM and repeated PM were 93.8% and 63.2%, respectively (P< 0.001). In contrary, non-repeated PM group and extra-pulmonary recurrence group showed worse 5-year survivals (21.3% and 25.9%; p=.91) (Figure 1B). Fifteen (32.6%) patients in repeated PM group achieved disease-free status while only 3 (8.6%) patients had stable disease status in patients who received chemotherapy. Repeated PM (HR=0.26, P=0.001) was a significant favorable prognostic factor after adjusting colorectal cancer stages, age, gender, number of pulmonary metastasis in multivariable analysis.
Conclusion : Approximately a half of the patients who received first PM developed recurrence. Repeated PM can improve survival in patients with intrapulmonary recurrence after first PM.
Methods : We reviewed medical records of 226 patients who underwent PM for pulmonary metastasis of colorectal cancer. Among them, 116 (51.3%) patients developed recurrence after first PM (Figure 1a). We analyzed long-term survivals of patients who developed intrapulmonary recurrence after first PM according to receiving second PM.
Results : After first PM, 81 patients had isolated pulmonary recurrence. Median follow duration was 31months. Among them, 46 patients underwent repeated PM and 35 patients were received chemotherapy or close observation. There was no significant difference in age, gender, colorectal cancer stages, surgical procedures, pulmonary metastasis number, laterality, mediastinal node metastasis, and chemotherapy between repeated PM and non-surgical groups (table). There was one operation mortality. Overall 5-year survival rates after first PM and repeated PM were 93.8% and 63.2%, respectively (P< 0.001). In contrary, non-repeated PM group and extra-pulmonary recurrence group showed worse 5-year survivals (21.3% and 25.9%; p=.91) (Figure 1B). Fifteen (32.6%) patients in repeated PM group achieved disease-free status while only 3 (8.6%) patients had stable disease status in patients who received chemotherapy. Repeated PM (HR=0.26, P=0.001) was a significant favorable prognostic factor after adjusting colorectal cancer stages, age, gender, number of pulmonary metastasis in multivariable analysis.
Conclusion : Approximately a half of the patients who received first PM developed recurrence. Repeated PM can improve survival in patients with intrapulmonary recurrence after first PM.
책임저자: In Kyu Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
발표자: Samina Park, E-mail : saminapark1203@gmail.com