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Posted by on May 8, 2013 in Colorectal cancer | 0 comments

In a nutshell

This article looks at results from 8 clinical studies where patients had surgery to remove lung metastases. Using patient data from these studies, the authors identified risk factors which can predict the 5 year survival rate.

Some background

Oligometastasis defines the spread of a primary cancer (in this case colorectal cancer) to a limited number of secondary sites. If there are only a few metastases (secondary tumors) in the lung, it may be possible to perform surgery to remove these tumors. Developing a prognostic model may help identify who will benefit most from invasive surgery to remove lung metastases. 

Methods & findings

The aim of this article was to review data on patients treated for lung metastases from colorectal cancer (CRC) to identify factors linked to long term survival rates. The analysis included data from 927 patients from 8 studies carried out between 1983 to 2008.
 
Results found that chemotherapy around the time of surgery and previously removed liver metastases had no influence on survival. 5 of the 13 risk factors that were investigated were significantly linked to long term survival.
Authors found that patients with a disease free interval greater than 36 months, a carcinoembryonic antigen (CEA) level less than 5, no more than 1 metastatic tumor, a metastatic tumor diameter less than 2 cm and no lymph node involvement in the chest had better 5 year survival rates. By combining these factors, a lung metastasis prognostic model was developed which could indicate the likelihood of a patient surviving longer than 5 years following surgery.
 

The bottom line

Overall, this article identifies 5 factors which may influence how long a patient survives following surgery to remove lung metastases from colorectal cancer.

The fine print

Results of this analysis are limited by the fact that the trials included in the analysis had different study methodologies. Patients who underwent surgery to remove lung metastases may also represent a selected group, with fewer associated conditions and in better general health that the overall general population.

What’s next?

Patients and doctors may find this article useful in determining the benefit of surgical resection of lung metastases. The opportunity of such an intervention should be carefully discussed with the treating oncologist.

Published By :

Annals of oncology

Date :

Apr 29, 2012

Original Title :

Colorectal cancer pulmonary oligometastases: pooled analysis and construction of a clinical lung metastasectomy prognostic model

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