Survival outcome in New Zealand after resection of colorectal cancer lung metastases

ANZ J Surg. 2013 Dec;83(12):959-62. doi: 10.1111/ans.12012. Epub 2012 Nov 27.

Abstract

Background: Colorectal cancer is the second most common type of solid organ cancer in New Zealand behind prostate cancer. Even with treatment, distant disease may develop in the liver and lungs. Surgical resection of isolated liver and/or lung metastasis is now commonly considered, but survival outcomes from the latter are not well described. This study aims to review the 5-year survival and prognostic factors of patients who have resection for lung metastasis of colorectal origin.

Methods: A retrospective audit of surgical resection for lung metastasis performed by thoracic departments of several tertiary referral centres within New Zealand was performed. The study period was between 1997 and 2011. Patients were identified through operative logs, audit databases, clinical case mix codes and pathology databases. Patient demographics, preoperative and post-operative variables were recorded. All patients were followed up for survival analysis. Mann-Whitney and chi-square tests were performed for data analysis. A P-value of less than 0.05 was significant.

Results: There were 106 (59 male) patients. Median age was 64 (inter-quartile range (IQR) 57-73) years. Median follow-up period was 30 (IQR 16-46) months. The 5-year overall and cancer-specific survival was 40% and 43%, respectively. The only good prognostic factor for survival after lung resection was a long disease-free interval (P = 0.04) between surgery for the colorectal primary and lung metastasis.

Conclusion: Lung resection for isolated colorectal metastases provides a reasonable 5-year survival. Outcomes from lung resection for colorectal metastases in New Zealand are comparable to that from international series.

Keywords: colorectal cancer; pulmonary metastases.

MeSH terms

  • Aged
  • Colonic Neoplasms / surgery
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Pneumonectomy
  • Prognosis
  • Rectal Neoplasms / surgery
  • Retrospective Studies
  • Time Factors