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Erschienen in: Updates in Surgery 4/2016

27.09.2016 | Original Article

Pulmonary metastasectomy in elderly colorectal cancer patients: a retrospective single center study

verfasst von: Mirko Barone, Marco Prioletta, Decio Di Nuzzo, Giuseppe Cipollone, Pierpaolo Camplese, Felice Mucilli

Erschienen in: Updates in Surgery | Ausgabe 4/2016

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Abstract

Colorectal cancer (CRC) is one of the most common malignancies worldwide and the lung is one of the most frequent sites for CRC metastasis. The geriatric population is increasing, but clinical decision making is often influenced by the effect of aging. For this reason, the elderly population does not often receive potentially curative cancer treatments as offered to younger ones. From January 2000 to March 2016, 21 elderly patients (older than 75 years) underwent pulmonary resections for colorectal cancer pulmonary metastases. A postoperative morbidity rate of 23.8 % and a 30-day mortality rate of 4.8 % were reported. A cumulative overall survival of 34.19 ± 23.51 months (95 % CI 23.71–50.28) and a disease-free interval of 24.62 ± 23.79 months (95 % CI 6.44–39.56) were observed. By considering only R0 surgically resected patients, the 1-, 3- and 5-year OS were 94.1, 59.5 and 21.2 % with a mean overall survival and disease-free interval of 51.10 ± 7.82 and 42.75 ± 9.35, respectively. Concerning risk factors, an important correlation between the number of pulmonary metastases, surgical radicality and overall survival was reported (p = 0.030 and p = 0.005, respectively). In summary, according to our series, pulmonary metastasectomy in selected elderly CRC oligometastatic patients seems to be safe and effective.
Literatur
2.
Zurück zum Zitat Jemal A, Center MM, DeSantis C, Ward EM (2010) Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev 19:1893–1907CrossRefPubMed Jemal A, Center MM, DeSantis C, Ward EM (2010) Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev 19:1893–1907CrossRefPubMed
3.
Zurück zum Zitat Yancik R, Ries LA (2004) Cancer in older persons: an international issue in an aging world. Semin Oncol 31:128–136CrossRefPubMed Yancik R, Ries LA (2004) Cancer in older persons: an international issue in an aging world. Semin Oncol 31:128–136CrossRefPubMed
4.
Zurück zum Zitat Treasure T, Milošević M, Fiorentino F, Macbeth F (2014) Pulmonary metastasectomy: what is the practice and where is the evidence for effectiveness? Thorax 69:946–949CrossRefPubMedPubMedCentral Treasure T, Milošević M, Fiorentino F, Macbeth F (2014) Pulmonary metastasectomy: what is the practice and where is the evidence for effectiveness? Thorax 69:946–949CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Gonzalez M, Poncet A, Combescure C, Robert J, Ris HB, Gervaz P (2013) Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol 20:572–579CrossRefPubMed Gonzalez M, Poncet A, Combescure C, Robert J, Ris HB, Gervaz P (2013) Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol 20:572–579CrossRefPubMed
7.
Zurück zum Zitat Yancik RM, Ries L (1997) Cancer and age: magnitude of the problem. In: Balducci L, Lyman GH, Ershler WB (eds) Comprehensive geriatric oncology. Harwood Academic Publishers, London, pp 95–103 Yancik RM, Ries L (1997) Cancer and age: magnitude of the problem. In: Balducci L, Lyman GH, Ershler WB (eds) Comprehensive geriatric oncology. Harwood Academic Publishers, London, pp 95–103
8.
9.
Zurück zum Zitat Pfannschmidt J, Muley T, Hoffmann H, Dienemann H (2003) Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg 126:732–739CrossRefPubMed Pfannschmidt J, Muley T, Hoffmann H, Dienemann H (2003) Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg 126:732–739CrossRefPubMed
10.
Zurück zum Zitat Riquet M, Foucault C, Cazes A, Mitry E, Dujon A, Le Pimpec Barthes F, Médioni J, Rougier P (2010) Pulmonary resection for metastases of colorectal adenocarcinoma. Ann Thorac Surg 89:375–380CrossRefPubMed Riquet M, Foucault C, Cazes A, Mitry E, Dujon A, Le Pimpec Barthes F, Médioni J, Rougier P (2010) Pulmonary resection for metastases of colorectal adenocarcinoma. Ann Thorac Surg 89:375–380CrossRefPubMed
11.
Zurück zum Zitat Embún R, Fiorentino F, Treasure T, Rivas JJ, Molins L; Grupo Español de Cirugía Metástasis Pulmonares de Carcinoma Colo-Rectal (GECMP-CCR) de la Sociedad Española de Neumoloña y Cirurña Torácica (SEPAR) (see appendix for membership of GECMP-CCR-SE. Pulmonary metastasectomy in colorectal cancer: a prospective study of demography and clinical characteristics of 543 patients in the Spanish colorectal metastasectomy registry (GECMP-CCR). BMJ Open 3(5). doi:10.1136/bmjopen-2013-002787 Embún R, Fiorentino F, Treasure T, Rivas JJ, Molins L; Grupo Español de Cirugía Metástasis Pulmonares de Carcinoma Colo-Rectal (GECMP-CCR) de la Sociedad Española de Neumoloña y Cirurña Torácica (SEPAR) (see appendix for membership of GECMP-CCR-SE. Pulmonary metastasectomy in colorectal cancer: a prospective study of demography and clinical characteristics of 543 patients in the Spanish colorectal metastasectomy registry (GECMP-CCR). BMJ Open 3(5). doi:10.​1136/​bmjopen-2013-002787
12.
Zurück zum Zitat Hachimaru A, Maeda R, Suda T, Takagi Y (2016) Repeat pulmonary resection for recurrent lung metastases from colorectal cancer: an analysis of prognostic factors. Interact Cardiovasc Thorac Surg Hachimaru A, Maeda R, Suda T, Takagi Y (2016) Repeat pulmonary resection for recurrent lung metastases from colorectal cancer: an analysis of prognostic factors. Interact Cardiovasc Thorac Surg
13.
Zurück zum Zitat Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84:324–338CrossRefPubMed Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84:324–338CrossRefPubMed
14.
Zurück zum Zitat Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113:37–49CrossRefPubMed Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113:37–49CrossRefPubMed
16.
17.
Zurück zum Zitat Borasio P, Gisabella M, Billé A, Righi L, Longo M, Tampellini M, Ardissone F (2011) Role of surgical resection in colorectal lung metastases: analysis of 137 patients. Int J Colorectal Dis 26:183–190. doi:10.1007/s00384-010-1075-6 CrossRefPubMed Borasio P, Gisabella M, Billé A, Righi L, Longo M, Tampellini M, Ardissone F (2011) Role of surgical resection in colorectal lung metastases: analysis of 137 patients. Int J Colorectal Dis 26:183–190. doi:10.​1007/​s00384-010-1075-6 CrossRefPubMed
20.
Zurück zum Zitat Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251CrossRefPubMed Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251CrossRefPubMed
21.
Zurück zum Zitat Melloni G, Doglioni C, Bandiera A, Carretta A, Ciriaco P, Arrigoni G et al (2006) Prognostic factors and analysis of microsatellite instability in resected pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 81:2008e13CrossRef Melloni G, Doglioni C, Bandiera A, Carretta A, Ciriaco P, Arrigoni G et al (2006) Prognostic factors and analysis of microsatellite instability in resected pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 81:2008e13CrossRef
22.
Zurück zum Zitat Onaitis MW, Petersen RP, Haney JC, Saltz L, Park B, Flores R et al (2009) Prognostic factors for recurrence after pulmonary resection of colorectal cancer metastases. Ann Thorac Surg 87:1684–1688CrossRefPubMed Onaitis MW, Petersen RP, Haney JC, Saltz L, Park B, Flores R et al (2009) Prognostic factors for recurrence after pulmonary resection of colorectal cancer metastases. Ann Thorac Surg 87:1684–1688CrossRefPubMed
23.
Zurück zum Zitat Rama N, Monteiro A, Bernardo JE, Eugénio L, Antunes MJ (2009) Lung metastases from colorectal cancer: surgical resection and prognostic factors. Eur J Cardiothorac Surg 35:444–449CrossRefPubMed Rama N, Monteiro A, Bernardo JE, Eugénio L, Antunes MJ (2009) Lung metastases from colorectal cancer: surgical resection and prognostic factors. Eur J Cardiothorac Surg 35:444–449CrossRefPubMed
24.
Zurück zum Zitat Iizasa T, Suzuki M, Yoshida S, Motohashi S, Yasufuku K, Iyoda A et al (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82:254–260CrossRefPubMed Iizasa T, Suzuki M, Yoshida S, Motohashi S, Yasufuku K, Iyoda A et al (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82:254–260CrossRefPubMed
25.
Zurück zum Zitat Bains MS, Ginsberg RJ, Jones WG II et al (1994) The clamshell incision: an improved approach to bilateral pulmonary and mediastinal tumor. Ann Thorac Surg. 58(1):30–32 (discussion 33) CrossRefPubMed Bains MS, Ginsberg RJ, Jones WG II et al (1994) The clamshell incision: an improved approach to bilateral pulmonary and mediastinal tumor. Ann Thorac Surg. 58(1):30–32 (discussion 33) CrossRefPubMed
26.
Zurück zum Zitat van der Veen AH, van Geel AN, Hop WC, Wiggers T (1998) Median sternotomy: the preferred incision for resection of lung metastases. Eur J Surg 164(7):507–512CrossRefPubMed van der Veen AH, van Geel AN, Hop WC, Wiggers T (1998) Median sternotomy: the preferred incision for resection of lung metastases. Eur J Surg 164(7):507–512CrossRefPubMed
27.
Zurück zum Zitat Cerfolio R, Bryant AS (2008) Is palpation of the nonresected pulmonary lobe(s) required for patients with non-small cell lung cancer? A prospective study. J Thorac Cardiovasc Surg 131:261–268CrossRef Cerfolio R, Bryant AS (2008) Is palpation of the nonresected pulmonary lobe(s) required for patients with non-small cell lung cancer? A prospective study. J Thorac Cardiovasc Surg 131:261–268CrossRef
28.
Zurück zum Zitat Meng D, Fu L, Wang L, Dai Y, Lv W, Zhang J, Hu J (2016) Video-assisted thoracoscopic surgery versus open thoracotomy in pulmonary metastasectomy: a meta-analysis of observational studies. Interact CardioVasc Thorac Surg 22(2):200–206. doi:10.1093/icvts/ivv309 CrossRefPubMed Meng D, Fu L, Wang L, Dai Y, Lv W, Zhang J, Hu J (2016) Video-assisted thoracoscopic surgery versus open thoracotomy in pulmonary metastasectomy: a meta-analysis of observational studies. Interact CardioVasc Thorac Surg 22(2):200–206. doi:10.​1093/​icvts/​ivv309 CrossRefPubMed
29.
Zurück zum Zitat Cattaneo SM, Park BJ, Wilton AS et al (2008) Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg 85:231–236CrossRefPubMed Cattaneo SM, Park BJ, Wilton AS et al (2008) Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg 85:231–236CrossRefPubMed
30.
Zurück zum Zitat Scott WJ, Allen MS, Darling G, Meyers B, Decker PA, Putnam JB, McKenna RW, Landrenau RJ, Jones DR, Inculet RI, Malthaner RA (2010) Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg. 139(4):976–981. doi:10.1016/j.jtcvs.2009.11.059 (discussion 981–983) CrossRefPubMed Scott WJ, Allen MS, Darling G, Meyers B, Decker PA, Putnam JB, McKenna RW, Landrenau RJ, Jones DR, Inculet RI, Malthaner RA (2010) Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg. 139(4):976–981. doi:10.​1016/​j.​jtcvs.​2009.​11.​059 (discussion 981–983) CrossRefPubMed
31.
Zurück zum Zitat Jung J, Song SY, Kim JH, Yu CS, Kim JC, Kim TW, Jeong SY, Kim SS, Choi EK (2015) Clinical efficacy of stereotactic ablative radiotherapy for lung metastases arising from colorectal cancer. Radiat Oncol 21(10):238. doi:10.1186/s13014-015-0546-x CrossRef Jung J, Song SY, Kim JH, Yu CS, Kim JC, Kim TW, Jeong SY, Kim SS, Choi EK (2015) Clinical efficacy of stereotactic ablative radiotherapy for lung metastases arising from colorectal cancer. Radiat Oncol 21(10):238. doi:10.​1186/​s13014-015-0546-x CrossRef
32.
Zurück zum Zitat Carrafiello G, Mangini M, Fontana F, Di Massa A, Ierardi AM, Cotta E, Piacentino F, NocchiCardim L, Pellegrino C, Fugazzola C (2012) Complications of microwave and radiofrequency lung ablation: personal experience and review of the literature. Radiol Med 117(2):201–213. doi:10.1007/s11547-011-0741-2 CrossRefPubMed Carrafiello G, Mangini M, Fontana F, Di Massa A, Ierardi AM, Cotta E, Piacentino F, NocchiCardim L, Pellegrino C, Fugazzola C (2012) Complications of microwave and radiofrequency lung ablation: personal experience and review of the literature. Radiol Med 117(2):201–213. doi:10.​1007/​s11547-011-0741-2 CrossRefPubMed
34.
Zurück zum Zitat Cassidy J, Saltz LB, Giantonio BJ, Kabbinavar FF, Hurwitz HI, Rohr UP (2010) Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies. J Cancer Res Clin Oncol 136(5):737–743. doi:10.1007/s00432-009-0712-3 CrossRefPubMed Cassidy J, Saltz LB, Giantonio BJ, Kabbinavar FF, Hurwitz HI, Rohr UP (2010) Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies. J Cancer Res Clin Oncol 136(5):737–743. doi:10.​1007/​s00432-009-0712-3 CrossRefPubMed
35.
Zurück zum Zitat VanCutsem E, Rivera F, Berry S, Kretzschmar A, Michael M, DiBartolomeo M, Mazier MA, Canon JL, Georgoulias V, Peeters M, Bridgewater J, Cunningham D, First BEAT investigators (2009) Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol 20(11):1842–1847. doi:10.1093/annonc/mdp233 CrossRef VanCutsem E, Rivera F, Berry S, Kretzschmar A, Michael M, DiBartolomeo M, Mazier MA, Canon JL, Georgoulias V, Peeters M, Bridgewater J, Cunningham D, First BEAT investigators (2009) Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol 20(11):1842–1847. doi:10.​1093/​annonc/​mdp233 CrossRef
Metadaten
Titel
Pulmonary metastasectomy in elderly colorectal cancer patients: a retrospective single center study
verfasst von
Mirko Barone
Marco Prioletta
Decio Di Nuzzo
Giuseppe Cipollone
Pierpaolo Camplese
Felice Mucilli
Publikationsdatum
27.09.2016
Verlag
Springer Milan
Erschienen in
Updates in Surgery / Ausgabe 4/2016
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-016-0399-3

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