TY - JOUR
T1 - Individual data meta-analysis for the study of survival after pulmonary metastasectomy in colorectal cancer patients
T2 - A history of resected liver metastases worsens the prognosis
AU - Zabaleta, Jon
AU - Iida, Tomohiko
AU - Falcoz, Pierre E.
AU - Salah, Samer
AU - Jarabo, José R.
AU - Correa, Arlene M.
AU - Zampino, Maria G.
AU - Matsui, Takashi
AU - Cho, Sukki
AU - Ardissone, Francesco
AU - Watanabe, Kazuhiro
AU - Gonzalez, Michel
AU - Gervaz, Pascal
AU - Emparanza, Jose I.
AU - Abraira, Víctor
N1 - Publisher Copyright:
© 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2018/7
Y1 - 2018/7
N2 - Objectives: To assess the impact of a history of liver metastases on survival in patients undergoing surgery for lung metastases from colorectal carcinoma. Methods: 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. Results: 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 (I2 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). Conclusions: 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).
AB - Objectives: To assess the impact of a history of liver metastases on survival in patients undergoing surgery for lung metastases from colorectal carcinoma. Methods: 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. Results: 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 (I2 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). Conclusions: 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).
KW - Colorectal cancer
KW - Individual data meta-analysis
KW - Liver
KW - Lung
KW - Metastasis
KW - Survival
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U2 - 10.1016/j.ejso.2018.03.011
DO - 10.1016/j.ejso.2018.03.011
M3 - Article
C2 - 29602524
AN - SCOPUS:85044397318
SN - 0748-7983
VL - 44
SP - 1006
EP - 1012
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 7
ER -