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Reuters Health Information (2006-04-12): Aggressive surgery can help treat lung and liver metastases


Aggressive surgery can help treat lung and liver metastases

Last Updated: 2006-04-12 17:41:39 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In certain patients with metastatic colorectal cancer (CRC), lung and liver resection can be performed safely, with good long-term outcomes, according to findings by Canadian researchers.

"Patients with hepatic and pulmonary metastases from CRC may benefit from aggressive surgical therapy," Dr. Alice C. Wei and colleagues from the University of Toronto observe in their paper, published in the March issue of the Journal of the American College of Surgery. The team came to this conclusion after examining the long-term outcomes of 39 patients who underwent surgical resection of both hepatic and pulmonary metastases from CRC.

Staged liver and lung metastasectomy from synchronously identified metastases was performed in 11 patients (28%). Sequential metastasectomy because of recurrent disease was performed in 28 patients (72%). The median disease-free survival after initial metastasectomy was 19.8 months. The median overall survival was 87 months.

The 5-year overall survival was 74% in patients who underwent multiple metastasectomies versus 42% for those who underwent a single metastasectomy.

No significant difference was observed in overall survival for patients with synchronous versus metachronous presentation of hepatic and pulmonary metastases.

In total, seven patients (18%) underwent at least two liver resections for recurrent disease and 12 (31%) underwent multiple lung resections.

Thus the researchers conclude that in selected patients the approach "is safe and results in excellent long term survival."

J Am Coll Surg 2006;202:468-475.

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