Recurrence-free survival curve for pulmonary metastasectomy in colorectal cancer plateaus at 3 years.

IF 2.4 3区 医学 Q2 SURGERY
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-05-27 DOI:10.1007/s13304-024-01874-8
Chihiro Yoshida, Sung Soo Chang, Taku Okamoto, Ryo Inada
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引用次数: 0

Abstract

Pulmonary metastasectomy in colorectal cancer (CRC) has encouraging results; however, specific criteria for lung resection and the timing of resection remain undetermined. Therefore, in this study, we aimed to examine the long-term prognosis and 10-year survival rates and analyze poor prognostic factors in patients who underwent resection of pulmonary metastases from CRC. This retrospective, single-institution study included 156 patients with controlled primary CRC and metastases confined to the lungs or liver who underwent pulmonary metastasectomy between 2005 and 2022. Statistical analyses were conducted using the X2 and two-tailed Student's t test to compare variables. The receiver operating characteristic (ROC) curve was used to determine the appropriate cut-off point for tumor size as a predictive factor of survival. Recurrence-free survival (RFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and non-parametric group comparisons were performed using log-rank tests. The 5- and 10-year OS rates were 67% and 59%, respectively. Further, there was no recurrence 38 months post-surgery, and the RFS curve plateaued. Moreover, by 88 months post-surgery, no deaths occurred, and the OS curve plateaued. Multivariate analysis revealed that a pulmonary metastatic tumor >14 mm and disease-free interval <2 years indicated poor prognosis. The RFS curve for pulmonary metastasectomy may plateau approximately 3 years after surgery. Pulmonary metastasectomy can achieve long-term survival in selected patients with CRC. Furthermore, surgical resection of recurrence after pulmonary metastasectomy may lead to better results. Thus, tumor size and disease-free interval may be independent prognostic factors.

Abstract Image

结直肠癌肺转移切除术的无复发生存期曲线在 3 年后趋于平稳。
结肠直肠癌(CRC)肺转移灶切除术取得了令人鼓舞的结果;然而,肺切除术的具体标准和切除时机仍未确定。因此,在本研究中,我们旨在研究接受 CRC 肺转移灶切除术的患者的长期预后和 10 年生存率,并分析不良预后因素。这项回顾性单机构研究纳入了 2005 年至 2022 年间接受肺转移灶切除术的 156 例原发性 CRC 患者,这些患者的转移灶局限于肺部或肝脏。统计分析采用 X2 和双尾学生 t 检验来比较变量。受体操作特征曲线(ROC)用于确定肿瘤大小作为生存预测因素的适当临界点。无复发生存期(RFS)和总生存期(OS)采用卡普兰-梅耶法估算,非参数组间比较采用对数秩检验。5年和10年的OS率分别为67%和59%。此外,术后38个月无复发,RFS曲线趋于平稳。此外,在术后88个月,无死亡病例发生,OS曲线也趋于平稳。多变量分析表明,肺转移瘤大于 14 毫米和无病间隔时间大于 10 个月的患者的无病间隔时间大于 10 个月。
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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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