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Eur J Cardiothorac Surg 2004;25:151-154
© 2004 Elsevier Science NL

Staged pulmonary and hepatic metastasectomy in colorectal cancer—is it worth it?

^a Department of Thoracic Surgery, Leeds General Infirmary, D Floor, Jubilee Building, Great George Street, Leeds LS1 3EX, UK
^b Department of Hepatobiliary Centre, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK

Received 8 May 2003; received in revised form 11 November 2003; accepted 17 November 2003.

^* Corresponding author. Tel.: +44-113-3925-737; fax: +44-113-3926-657
e-mail: thorpyat{at}aol.com

Objective: Resection of isolated pulmonary and hepatic metastases from colorectal cancer can offer potential cure. However, little data is available to determine the results of staged hepatic and pulmonary resections in the same patient. Methods: We retrospectively reviewed all patients who underwent staged hepatic and pulmonary metastasectomy for colorectal cancer in our institute from September 1998 to May 2002. Probability of survival was estimated by the Kaplan–Meier method. Results. Thirty-three metastasectomies (seven redo) were carried out in 26 patients. There were 19 male and 7 female patients with a mean age of 61 years (range 34–76 years). The mean disease-free interval for hepatic and pulmonary resection was 21.8 and 23.9 months, respectively. Sternotomy, thoracotomy and video assisted thoracoscopic approach were used in 3.03, 72.7 and 24.2% of patients, respectively. Wedge excision, lobectomy and pneumonectomy were carried out in 87.87, 9.09 and 3.03% of cases, respectively. There was one hospital death following acute respiratory failure after pneumonectomy. Mean follow-up was 23.3 months (range 2–71 months). The mean survival after last pulmonary resection was 34.7 months (SE 3.03 and 95% CI of 28.8–40.6). Conclusion: Our results support aggressive surgical management of pulmonary and hepatic metastases in colorectal cancer.

Key Words: Metastasectomy • Colorectal cancer VATS • Lung resection • Lung metastases • Hepatic metastases

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