Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

Eliza A. Hawkes, George Ladas, David Cunningham, Andrew G. Nicholson, Katharina Wassilew, Yolanda Barbachano, Gihan Ratnayake, Sheela Rao, Ian Chau

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23 Citations (Scopus)

Abstract

Background: Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC). Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy.Methods: Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Results: Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS) and those who underwent surgery alone (S) respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Conclusions: Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable.

Original languageEnglish
Article number326
Number of pages12
JournalBMC Cancer
Volume12
DOIs
Publication statusPublished - 1 Aug 2012
Externally publishedYes

Keywords

  • Colorectal cancer
  • lung resection
  • peri-operative chemotherapy

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