| Theme |
How to Manage Distant Metastases from Gastrointestinal Cancer? |
| Title |
Surgical Treatment for Pulmonary Metastases from Colorectal Cancer : Indications, Technique, and Results |
| Author |
Masahiko Higashiyama |
Department of Thoracic Surgery, OMCCC Diseases |
| Author |
Koji Takami |
Department of Thoracic Surgery, OMCCC Diseases |
| Author |
Naozumi Higaki |
Department of Thoracic Surgery, OMCCC Diseases |
| Author |
Kazuyuki Oda |
Department of Thoracic Surgery, OMCCC Diseases |
| Author |
Ken Kodama |
Department of Thoracic Surgery, OMCCC Diseases |
| Author |
Shingo Noura |
Department of Surgery, OMCCC Diseases |
| Author |
Masayuki Ohue |
Department of Surgery, OMCCC Diseases |
| Author |
Kohei Murata |
Department of Surgery, Suita Municipal Hospital |
| Author |
Hideoki Yokouchi |
Department of Surgery, Suita Municipal Hospital |
| Author |
Masao Kameyama |
Department of Surgery, Bell Land General Hospital |
| [ Summary ] |
Surgical indications, techniques and examination of results of metastasectomies for lung metastases from colorectal cancer have been introduced in our institute. Pulmonary metastasectomy was aggressively performed on patients, in whom the number of pulmonary metastases was less than three, with signs of neither mediastinal nodal swelling, malignant pleural effusion nor dissemination on preoperativly in the chest as determined through computed tomography. Surgical treatment was also carefully selected, when the number was from four to six, or when mediastino-hilar nodes had radiologically related swelling. While lobectomy was usually conducted in the case of metastasis, with a diameter of more than 3 cm, a pulmonary wedge or segmental resections were performed. In such limited resections for lung metastases, intraoperative lavage cytologic techniques for surgical margins were routinely performed to check the tumor-free status at the surgical margin. Furthermore, the clinical significance of pleural lavage cytology immediately after thoracotomy for lung metastases from colorectal cancer was described. Postoperative 3-year-and 5-year-survival rates for patients undergoing pulmonary metastasectomy for this disease, in our institute, were 59 % and 47 % respectively. Mediastinal lymph node metastases (pN 2), in complete resection, and elevated prethoracotomy CEA levels were unfavorable prognostic factors for surgical treatment of patients with this metastatic disease. |