Surgical treatment of pulmonary metastasis in colorectal cancer patients: Current practice and results.

Details

Serval ID
serval:BIB_D0E66EE29AF5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Surgical treatment of pulmonary metastasis in colorectal cancer patients: Current practice and results.
Journal
Critical reviews in oncology/hematology
Author(s)
Zellweger M., Abdelnour-Berchtold E., Krueger T., Ris H.B., Perentes J.Y., Gonzalez M.
ISSN
1879-0461 (Electronic)
ISSN-L
1040-8428
Publication state
Published
Issued date
07/2018
Peer-reviewed
Oui
Volume
127
Pages
105-116
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Colorectal cancer (CRC) is a frequently occurring disease, yet diagnosed at a local stage in only 40% of cases. Lung metastases (LM) appear in 5-15% of patients and, left untreated, carry a very poor prognosis. Some CRC patients may benefit from a potentially curative LM resection, but success and benefit are difficult to predict. We discuss prognostic factors of survival after lung metastasectomy in CRC patients under several scenarios (with/ without prior liver metastases; repetitive pulmonary resections). We reviewed all studies (2005-2015) about pulmonary metastases surgical management with curative intent in CRC patients, with a minimum threshold on the number of patients reported (without prior liver metastases: n ≥ 100; with prior resection of liver metastases: n ≥ 50; repetitive thoracic surgery: n ≥ 30). The picture of the prognostic factors of survival is nuanced: surgical management demonstrates clear successes and steady progress, yet there is no single success criterion; stratification of patients and selection bias impact the conclusions. Surgical management of liver and lung metastases may prolong life or cure CRC patients, provided the lesions are fully resected and patients carefully selected. Repeat lung metastasectomy is a safe approach to treat patients in selected cases. In conclusion, there is no standard for surgical management in CRC patients with pulmonary metastases. Patients with isolated unilateral lung metastasis with normal CEA level and no lymph node involvement benefit the most from surgery. Most series report good results in highly selected patients, but instances of long-term disease-free survival remain exceptional.
Keywords
Colorectal Neoplasms/secondary, Colorectal Neoplasms/surgery, Disease-Free Survival, Humans, Lung Neoplasms/pathology, Lung Neoplasms/surgery, Metastasectomy/methods, Metastasectomy/standards, Pneumonectomy/methods, Pneumonectomy/standards, Practice Guidelines as Topic, Practice Patterns, Physicians'/statistics & numerical data, Prognosis, Colorectal cancer, Liver, Lung, Metastasis, Surgery, Thorax
Pubmed
Web of science
Create date
25/06/2018 10:25
Last modification date
29/06/2023 6:47
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