Abstract 122P
Background
The lung is one of the most common sites of colorectal cancer (CRC) metastases. Surgical resection of metastases is the only curative treatment for these patients although most of patients recur. Which patients benefit from lung resection is still under discussion. The aim of the study is to explore the prognostic value of clinical, histological and molecular variables in patients who have undergone lung resection.
Methods
Clinical, molecular and pathological data from patients who underwent lung metastasectomy of CRC in Sant Pau Hospital between September 2011 and October 2023 were collected. Histopathological changes in lung parenchyma such as immune phenotype (IP) and histological growth pattern (HGP) were documented.
Results
The study included 61 patients, 43 (70.5%) were males. Thirty-three (54.1%) patients received perioperative chemotherapy and the median size of lung metastases was 13.0mm (4-57mm). Most patients had a lung-limited disease (85.2%). The median overall survival (OS) was 73.1 months (58.5-87.7) and the median recurrence-free survival (RFS) was 17.5 months (11.2-23.9). Thirty-five (57.4%) patients had a lung recurrence and in 14 (40%) patients a second pulmonary surgery was performed. Thirty-six patients (59.0%) had a NRAS/KRAS or BRAF mutation, 21 patients (34.4%) were RAS wild type and 4 patients (6.5%) had no molecular data available. The IP and HGP was assessed in 51 patients. Thirty-one (60.8%) had an expansive HGP and twenty (39.2%) an infiltrative HGP. Seven (13.7%) patients had a desertic IP and thirty-one (60.8%) an inflamed IP. The survival analysis showed that the desertic IP was associated with worse RFS: 4.03 months vs 17.5 months in the infiltrated tumors (p=0.047). Stage I or II at CRC diagnosis was associated to better RFS: 42.7m vs 12.6m (HR 2.29; 95% CI 1.14-4.61; p=0.02) and single lung metastasis was related to a better OS: 80.3m vs 28.6m (HR 0.34; CI 95% 0.14-0.79; p=0.01).
Conclusions
Patients with single lung metastasis, stage I/II at diagnosis and CD8 infiltration have better prognosis. Assess the prognosis of patients with oligometastatic disease can help decide which patients benefit from a surgical approach.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.