초록접수 현황
| 19F-219 | 구연 미채택시 포럼 발표 |
Prognosis of Repeated Pulmonary Metastasectomy for Isolated Pulmonary Recurrence after Initial Pulmonary Metastasectomy in Patients with Colorectal Cancer
Sumin Shin, Tae Ho Kim, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim, Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : The purpose of this study was to investigate survival outcomes after repeated pulmonary metastasectomy (PM) for isolated pulmonary recurrence of colorectal cancer (CRC).
Methods : From 1994 to 2017, a total of 212 patients who had recurrent pulmonary metastasis without extrapulmonary disease after initial PM were identified. Of those, 144 patients (68%) received repeated PM (RPM group) and the remaining 68 (32%) received non-surgical management, including chemotherapy (n=42, 19.8%), radiotherapy (n=12, 5.7%), and best supportive care (n=14, 6.6%) (non-RPM group). Their clinico-pathologic features and survival outcomes were compared between the two groups. In the RPM group, multivariate analysis was conducted to identify prognostic factors after repeated PM using Cox regression model.
Results : Compared with the non-RPM group, more patients in the RPM group had one or two metastatic nodules, unilateral metastases, longer disease-free interval (DFI) than 12 months, and lower CEA level. Otherwise, there were no significant differences between the two groups in terms of age, sex, and primary CRC features. The RPM group showed significantly better 5-year overall survival than the non-RPM group after lung recurrence (58.2% vs 12.8%, p<0.001). In the RPM group, multivariate analysis identified DFI less than 12 months after initial PM and bilateral metastases as poor prognostic factors for both overall and disease-free survivals.
Conclusion : In selected patients, repeated PM for isolated pulmonary recurrence of CRC could provide long-term survival. The shorter DFI and bilateral lung metastases were significantly associated with poor prognoses after repeated PM.
Methods : From 1994 to 2017, a total of 212 patients who had recurrent pulmonary metastasis without extrapulmonary disease after initial PM were identified. Of those, 144 patients (68%) received repeated PM (RPM group) and the remaining 68 (32%) received non-surgical management, including chemotherapy (n=42, 19.8%), radiotherapy (n=12, 5.7%), and best supportive care (n=14, 6.6%) (non-RPM group). Their clinico-pathologic features and survival outcomes were compared between the two groups. In the RPM group, multivariate analysis was conducted to identify prognostic factors after repeated PM using Cox regression model.
Results : Compared with the non-RPM group, more patients in the RPM group had one or two metastatic nodules, unilateral metastases, longer disease-free interval (DFI) than 12 months, and lower CEA level. Otherwise, there were no significant differences between the two groups in terms of age, sex, and primary CRC features. The RPM group showed significantly better 5-year overall survival than the non-RPM group after lung recurrence (58.2% vs 12.8%, p<0.001). In the RPM group, multivariate analysis identified DFI less than 12 months after initial PM and bilateral metastases as poor prognostic factors for both overall and disease-free survivals.
Conclusion : In selected patients, repeated PM for isolated pulmonary recurrence of CRC could provide long-term survival. The shorter DFI and bilateral lung metastases were significantly associated with poor prognoses after repeated PM.
책임저자: Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Sumin Shin, E-mail : essennee@gmail.com