154P - Analysis of factors affecting survival in patients with simultaneous liver and pulmonary metastases from colorectal cancer

Date 07 May 2017
Event ELCC 2017
Session Poster Display Session
Topics Thoracic malignancies
Presenter Franco Lumachi
Citation Annals of Oncology (2017) 28 (suppl_2): ii52-ii55. 10.1093/annonc/mdx094
Authors F. Lumachi1, S.M. Basso2, U. Zuccon3, F. Maffeis4, A. Del Conte5, P. Ubiali2
  • 1Department Of Surgery, Oncology & Gastroenterology, University of Padua, School of Medicine, 35128 - Padova/IT
  • 2Department Of Surgery, S. Maria degli Angeli Hospital, Pordenone/IT
  • 3Pneumology, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT
  • 4Department Of Surgery, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT
  • 5Medical Oncology, S. Maria degli Angeli Hospital, 33170 - Pordenone/IT

Abstract

Background

In patients with colorectal cancer (CRC) the presence of simultaneous liver (LMs) and pulmonary metastases (PMs) is uncommon, but may significantly affect overall survival (OS). The aim of this study was to identify the prognostic factors (PFs) influencing OS in such a group of patients.

Methods

We retrospectively reviewed the medical records of 36 patients (mean age 62.2±10.5 years) with CRC who underwent curative surgical resection and developed PMs during follow up requiring video-assisted thoracoscopic (VATS) metastasectomy. There were 21 (58.3%) males and 15 (41.7%) females. Twenty (55.6%) patients had already LMs at the time of VATS. Survival curves were estimated by Kaplan-Meyer method and compared with log rank testing. Cox proportional hazard model (HR) calculation (stepwise logistic regression) was used in the multivariate analysis, to identify the independent variables. A p-value of < 0.01 (two-tailed) was considered statistically significant.

Results

The OS of the entire population ranged widely (30.6±25.1 months), according to patient age (p = 0.004), presence of involved mesenteric (p = 0.0003) or thoracic (p = 0.0001) lymph nodes, number of the involved nodes (p = 0.006), and simultaneous LMs and PMs (p = 0.0002). There was no relationship between gender (p = 0.67) or the mean size of metastases (p = 0.53) and OS. A tendency towards a correlation between age and the presence of lymph node involvement (p = 0.050) was also observed. The regression analysis showed that the number of LMs (HR = 1.37, 95% CI: 1.14-1.67, p = 0.0011), and the presence of node involvement, both thoracic (HR = 11.49, 95% CI: 1.49-88.58, p = 0.0191) and mesenteric (HR = 5.79, 95% CI: 1.27-26.30, p = 0.0230), were independent parameters affecting OS.

Conclusions

In patients with CRC with both LMs and PMs only lymph node involvement and their number should be considered as negative PFs. In conclusion, the results of liver metastasectomy are independent of age, gender, and size of metastases, and thus this therapeutic approach should be suggested in all node-negative patients suitable for surgery, regardless of other PFs.

Clinical trial identification

Legal entity responsible for the study

Università degli Studi di Padova

Funding

Università degli Studi di Padova

Disclosure

All authors have declared no conflicts of interest.