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Surgical management in lung metastases from colorectal cancer.

BACKGROUND
Colorectal cancer is a non-aggressive slow-growing disease. Surgery is often considered for the management of metastases. Chemotherapeutical agents may offer tumor reduction but radical tumor remission can only be achieved by surgery. The aim of the present study was to show the evolution of patients with lung metastases from colorectal cancer, treated with surgery.


PATIENTS AND METHODS
Five hundred and seventy-nine (male 327, female 252, median age 60 years [range 30-87 years], disease stage IV) patients with colorectal cancer were evaluated. Histology showed adenocarcinoma with 94% moderate differentiation. Sixty-six patients (11.40%) had only lung metastasis (single or multiple deposits). Of these 66 patients, 57 were treated with surgery (pneumonectomy, lobectomy or nodule excision) and in 52/57 (91.23%) the tumor was removed.


RESULTS
In 29 patients (50.88%) the disease recurred 8 months after surgery, at the earliest; however, no recurrence was observed in 28 patients (49.12%) during 2-8 years of follow-up after the operation. Five-year survival was 32.69%.


CONCLUSION
Metastectomy of lung metastasis from primary colorectal cancer may achieve long-term survival without recurrence in a large percentage of patients.