Pulmonary resection for metastases from colorectal cancer.

Introduction: The lung is the most common extraabdominal site for metastases from colorectal cancer. Patients with untreated metastatic disease have a median survival of less than 10 months and a 5-year survival of less than 5%. The purpose of this study was to evaluate long-term survival in patients who underwent pulmonary resection for metastases from colorectal cancer.

Methods: Between January 1990 and January 2005, 23 patients underwent 29 operations for resection of lung metastases.

Results: Median age was 68 years (range: 46-80 years). Median follow-up was 30 months (range: 12-149 months). The 2- and 5-year overall survival rates were 64 and 26%, respectively. Of the 23 patients, 16 patients had a solitary lesion, and seven patients had multiple lesions. The 5-year survival rates were 23 and 33%, respectively (not significant). The median disease-free interval (DFI)--the interval between colon resection and the appearance of lung metastases--was 43 months (1-168). Ten patients had DFIs <36 months, and 13 patients had DFIs >36 months. The 3-year survival rates were 20 and 38%, respectively (not significant). Recurrence of lung metastases was diagnosed in seven patients; three patients underwent second resections. They are alive today, with a median follow-up of 18 months. Patients who did not undergo second resections had a median survival of 12 months.

Conclusions: Pulmonary resection for metastases from colorectal cancer does produce longer survival, even in patients with multiple lesions and recurrent metastases.