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Combined resection of colorectal hepatic-pulmonary metastases shows improved outcome over chemotherapy alone.
MedLine Citation:
PMID:  23314791     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The objective of this retrospective study was to assess the survival of patients after resection of hepatic and pulmonary colorectal metastases to identify predictors of long-term survival. METHODS: Patients receiving chemotherapy alone were compared to patients receiving surgery and chemotherapy in a matched-pair analysis with the following criteria: UICC stage, grading, and date of initial primary tumor occurrence. RESULTS: A total of 30 patients with liver and lung metastases of colorectal carcinoma underwent resection. In 20 cases, complete resection was achieved (median survival, 67 months). Incomplete resection and preoperatively elevated carcinoembryonic antigen (CEA) levels are independent risk factors for reduced survival. Patients developing pulmonary metastases prior to hepatic metastases had the worst prognosis. Surgical resection significantly increased survival compared to chemotherapy alone in matched-pair analysis (65 vs. 30 months, p = 0.03). CONCLUSIONS: Incomplete resection and elevated CEA levels are predictors of poor outcome. Matched-paired analysis confirmed that surgical resection in combination with chemotherapy appears to be superior to chemotherapy alone.
Authors:
Georgios Meimarakis; Martin Angele; Claudius Conrad; Rolf Schauer; Rolf Weidenhagen; Alexander Crispin; Clemens Giessen; Gerhard Preissler; Max Wiedemann; Karl-Walter Jauch; Volker Heinemann; Sebastian Stintzing; Rudolf A Hatz; Hauke Winter
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-13
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie     Volume:  -     ISSN:  1435-2451     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of General Thoracic Surgery, University of Munich-Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.
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