Abstract
Opportunities to treat pulmonary metastasis of colorectal cancer have been increasing with a rise in primary diseases and advances in chemotherapy, and the indications are specified in the Japanese Society for Cancer of the Colon and Rectal (JSCCR) Guidelines 2014. However, the mechanism of metastasis may be anatomically different between colon and rectal cancers, and we considered that the indication of lung resection can be more accurately specified by the detailed analysis of prognostic indicators after lung resection. Thus, we divided 53 patients treated with lung resection for pulmonary metastasis of colorectal cancer at our department into 2 groups for comparison: those with metastases of colon and rectal cancers. The 5-year survival rates after resection of pulmonary metastasis were 56.8, 55.0, and 59.1% in all colorectal, colon, and rectal cancer patients, respectively. In the colon cancer patients, the outcome was significantly poorer in those with multiple pulmonary metastases. In the rectal cancer patients, the outcome was significantly poorer in those with a maximum lung tumor diameter of 20 mm or greater, those with an elevated carcinoembryonic antigen (CEA) level before lung resection, and those treated with chemotherapy after lung resection. The surgical indication should be investigated based on these factors.
