Individual data meta-analysis for the study of survival after pulmonary metastasectomy in colorectal cancer patients: A history of resected liver metastases worsens the prognosis.

Détails

ID Serval
serval:BIB_AB7EBDD07F55
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Individual data meta-analysis for the study of survival after pulmonary metastasectomy in colorectal cancer patients: A history of resected liver metastases worsens the prognosis.
Périodique
European journal of surgical oncology
Auteur⸱e⸱s
Zabaleta J., Iida T., Falcoz P.E., Salah S., Jarabo J.R., Correa A.M., Zampino M.G., Matsui T., Cho S., Ardissone F., Watanabe K., Gonzalez M., Gervaz P., Emparanza J.I., Abraira V.
ISSN
1532-2157 (Electronic)
ISSN-L
0748-7983
Statut éditorial
Publié
Date de publication
07/2018
Peer-reviewed
Oui
Volume
44
Numéro
7
Pages
1006-1012
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis
Publication Status: ppublish
Résumé
To assess the impact of a history of liver metastases on survival in patients undergoing surgery for lung metastases from colorectal carcinoma.
We reviewed recent studies identified by searching MEDLINE and EMBASE using the Ovid interface, with the following search terms: lung metastasectomy, pulmonary metastasectomy, lung metastases and lung metastasis, supplemented by manual searching. Inclusion criteria were that the research concerned patients with lung metastases from colorectal cancer undergoing surgery with curative intent, and had been published between 2007 and 2014. Exclusion criteria were that the paper was a review, concerned surgical techniques themselves (without follow-up), and included patients treated non-surgically. Using Stata 14, we performed aggregate data and individual data meta-analysis using random-effect and Cox multilevel models respectively.
We collected data on 3501 patients from 17 studies. The overall median survival was 43 months. In aggregate data meta-analysis, the hazard ratio for patients with previous liver metastases was 1.19 (95% CI 0.90-1.47), with low heterogeneity (I <sup>2</sup> 4.3%). In individual data meta-analysis, the hazard ratio for these patients was 1.37 (95% CI 1.14-1.64; p < 0.001). Multivariate analysis identified the following factors significantly affecting survival: tumour-infiltrated pulmonary lymph nodes (p < 0.001), type of resection (p = 0.005), margins (p < 0.001), carcinoembryonic antigen levels (p < 0.001), and number and size of lung metastases (both p < 0.001).
A history of liver metastases is a negative prognostic factor for survival in patients with lung metastases from colorectal cancer. We registered the meta-analysis protocol in PROSPERO (CRD42015017838).
Mots-clé
Aged, Carcinoembryonic Antigen/blood, Colorectal Neoplasms/mortality, Colorectal Neoplasms/pathology, Disease-Free Survival, Female, Hepatectomy, Humans, Liver Neoplasms/secondary, Liver Neoplasms/surgery, Lung Neoplasms/secondary, Lung Neoplasms/surgery, Lymph Nodes/pathology, Male, Margins of Excision, Metastasectomy, Middle Aged, Pneumonectomy, Prognosis, Proportional Hazards Models, Risk Factors, Survival Rate, Thoracic Surgery, Video-Assisted, Tumor Burden, Colorectal cancer, Individual data meta-analysis, Liver, Lung, Metastasis, Survival
Pubmed
Web of science
Création de la notice
12/04/2018 17:20
Dernière modification de la notice
20/08/2019 15:15
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