TY - JOUR
T1 - Effect of primary colorectal cancer tumor location on survival after pulmonary metastasectomy
AU - MD Anderson Pulmonary Metastasectomy Working Group
AU - Corsini, Erin M.
AU - Mitchell, Kyle G.
AU - Correa, Arlene
AU - Morris, Van K.
AU - Antonoff, Mara B.
AU - Zhou, Nicolas
AU - Hofstetter, Wayne L.
AU - Mehran, Reza J.
AU - Rice, David C.
AU - Roth, Jack A.
AU - Sepesi, Boris
AU - Swisher, Stephen G.
AU - Vaporciyan, Ara A.
AU - Walsh, Garrett L.
N1 - Publisher Copyright:
© 2020 The American Association for Thoracic Surgery
PY - 2021/7
Y1 - 2021/7
N2 - Objectives: Although colorectal cancer bowel segment location has been shown to independently predict the outcomes in early stage disease, it has not been previously studied in the setting of pulmonary metastases. We sought to determine whether colorectal cancer location affects survival after pulmonary metastasectomy. Methods: Patients who had undergone pulmonary metastasectomy for colorectal cancer at a single institution from 2011 to 2018 were reviewed. Univariable and multivariable Cox regression analyses were performed to identify predictors of overall survival and disease-free survival. The Kaplan-Meier survival method was used to determine differences between groups. Results: A total of 194 patients were evaluated. The median follow-up, survival time, and 5-year survival rate were 36.8 months, 75.8 months, and 57%, respectively, and 122 patients (63%) had experienced disease recurrence at any location. On univariable analysis, age, primary tumor location, pulmonary nodule size, ≥3 pulmonary nodules, and intrathoracic nodal disease were associated with overall survival. On multivariable analysis, patients with left-sided tumors experienced a survival benefit (hazard ratio, 0.31; P =.036). Kaplan-Meier analysis revealed a median survival time of 90 months (95% confidence interval, 82 months to not reached) compared with 55 months (95% confidence interval, 49 months to not reached) for patients with left-sided and rectal tumors, respectively, after metastasectomy (P =.078). Location was not associated with disease-free survival on Cox multivariable regression. Conclusions: We found that left-sided colorectal cancer is associated with prolonged survival after pulmonary metastasectomy. Future investigations are required to determine the validity of such findings, including the effect of location in the prognostication for patients who are candidates for pulmonary metastasectomy.
AB - Objectives: Although colorectal cancer bowel segment location has been shown to independently predict the outcomes in early stage disease, it has not been previously studied in the setting of pulmonary metastases. We sought to determine whether colorectal cancer location affects survival after pulmonary metastasectomy. Methods: Patients who had undergone pulmonary metastasectomy for colorectal cancer at a single institution from 2011 to 2018 were reviewed. Univariable and multivariable Cox regression analyses were performed to identify predictors of overall survival and disease-free survival. The Kaplan-Meier survival method was used to determine differences between groups. Results: A total of 194 patients were evaluated. The median follow-up, survival time, and 5-year survival rate were 36.8 months, 75.8 months, and 57%, respectively, and 122 patients (63%) had experienced disease recurrence at any location. On univariable analysis, age, primary tumor location, pulmonary nodule size, ≥3 pulmonary nodules, and intrathoracic nodal disease were associated with overall survival. On multivariable analysis, patients with left-sided tumors experienced a survival benefit (hazard ratio, 0.31; P =.036). Kaplan-Meier analysis revealed a median survival time of 90 months (95% confidence interval, 82 months to not reached) compared with 55 months (95% confidence interval, 49 months to not reached) for patients with left-sided and rectal tumors, respectively, after metastasectomy (P =.078). Location was not associated with disease-free survival on Cox multivariable regression. Conclusions: We found that left-sided colorectal cancer is associated with prolonged survival after pulmonary metastasectomy. Future investigations are required to determine the validity of such findings, including the effect of location in the prognostication for patients who are candidates for pulmonary metastasectomy.
KW - colorectal cancer
KW - left colon cancer
KW - metastases
KW - pulmonary metastasectomy
KW - right colon cancer
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U2 - 10.1016/j.jtcvs.2020.03.181
DO - 10.1016/j.jtcvs.2020.03.181
M3 - Article
C2 - 32713636
AN - SCOPUS:85085750459
SN - 0022-5223
VL - 162
SP - 296
EP - 305
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 1
ER -