Clinical Gastroenterology Vol.15 No.12(5-3)

Theme Up-to-date Therapuetic Strategy for Advanced Colorectal Cancer
Title Surgical Treatment for Lung Metastasis in Colorectal Cancer
Publish Date 2000/11
Author Yuichi Ozeki Surgery II, National Defence Medical Collage
[ Summary ] Surgical treatment for lung metastasis of colorectal cancer has been reported to be efficacious in selected patients. In our study, 5-and 10-year survival rates after pulmonary metastatectomy were 35.0% and 21.2%, respectively. Patients with lung metastases of greater than 3 cm, lymph node metastasis, local recurrence or multiple organ metastases, had poorer prognosis than other cases. No patients with local recurrence or lymph node metastasis had 3-year survival rates. The number of metastasis, disease free intervals (DFI) or unilateral/bilateral conditions did not affect the prognosis for patients. Most metastatic lung tumors expressed CA19-9 or SLX, immunohisto chemically. These carbohydrate determinants may be involved in the adhesion of cancer cells to vascular endothelial cells during the course of the hematogenous metastasis of cancer. High levels of nm23 expression were significantly associated with multiple organ metastasis and poorer prognosis.
Lung metastases of colorectal cancer should be detected and resected before growing to more than 3cm in diameter. Local recurrence or lymph node metastasis were thought to be contraindications forsurgical treatment of lung metastasis.
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