Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2010; 16(26): 3318-3324
Published online Jul 14, 2010. doi: 10.3748/wjg.v16.i26.3318
Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer
Wen-Hua Li, Jun-Jie Peng, Jia-Qing Xiang, Wei Chen, San-Jun Cai, Wen Zhang
Wen-Hua Li, Wen Zhang, Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Jun-Jie Peng, San-Jun Cai, Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Jia-Qing Xiang, Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Wei Chen, Department of Biostatistics, University of Michigan, Ann Arbor, MI 48710, United States
Author contributions: Li WH and Peng JJ contributed equally to this work; Li WH, Peng JJ, Zhang W, Cai SJ and Xiang JQ designed study; Chen W contributed statistical analysis; Li WH and Peng JJ collected and interpreted the data; Li WH, Peng JJ and Zhang W wrote the paper.
Supported by The Grant from Shanghai Science and Technology Committee, No. 09411967000
Correspondence to: Wen Zhang, Associate Professor, Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai 200032, China. whliiris@hotmail.com
Telephone: +86-21-64175590 Fax: +86-21-64035387
Received: March 23, 2010
Revised: April 22, 2010
Accepted: April 29, 2010
Published online: July 14, 2010
Abstract

AIM: To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer.

METHODS: Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chemotherapy was evaluated. Patients’ outcome and predictive factors for overall survival were also investigated by univariate and multivariate analysis.

RESULTS: A total of 70 patients were included in the study. After standardized first-line chemotherapy, only 4 patients (5.7%) were converted to resectable disease. The median overall survival time in all patients was 19 mo (95% CI: 12.6-25.4), with a 2-year overall survival rate of 38.8%. No survival difference was found among different first-line chemotherapeutic regimens. Prognostic analysis demonstrated that only the first response assessment for first-line treatment was the independent factor for predicting overall survival. The median survival time in partial response, stable disease and progressive disease patients were 27 mo, 16 mo and 8 mo (P = 0.00001).

CONCLUSION: Pulmonary metastasectomy can only be performed in a small part of unresectable lung metastases patients after chemotherapy. Patients’ first response assessment is an important prognostic factor.

Keywords: Colorectal cancer; Lung; Metastases; Chemotherapy