부산대학교 도서관

Background Colorectal cancer is one of the most common types of cancer in developed countries. Approximately 10% of patients with this diagnosis develop pulmonary metastases, although only 2-4% of them have pulmonary metastases as the only relapse localization. Objectives Pulmonary metastases study derived from colorectal cancer, establishing the prognosis of the disease according to different parameters. Thus, valuable prognostic factors are evaluated, establishing with the utmost precision their indications for resection. Materials and methods Retrospective, descriptive and analytical observational study was performed on 192 patients, who underwent surgery at our service, between the years 2003 and 2012. Results The study included 192 patients, of whom 81 were lung metastasis from colorectal cancer. Their ages were between 6 and 83 years old, with a mean of age of 55.74 years (39.87-71.61). 48(59.3%) were men and 33(40.7%), women. In the univariate analysis, of the 29 potential prognostic factors studied, statistically significant were primary pN and tumor stage (p=0.001/0.020), DFI (disease free interval) <24 months (p=0.039), number of metastasis higher than 3 (p=0.010), bilaterality (p=0.012), bilobarity (p=0.010) of PM, brain metastasis (p=0.022), ovarian metastasis (p=0.001) and IRLM groups (p=0.022). In the multivariate analysis, only the pN of the primary tumor (p=0.003) was observed statistically significant together with ovarian metastasis (p=0.030). Discussion The PMCRC are the metastasis most frequently indicated for resective surgery, with criteria of surgical radicality. In the univariate analysis, pN and primary tumor stage, DFI <24 months, number of metastasis greater than 3, bilaterality, bilobarity of PM, brain metastasis, ovarian metastasis and IRLM groups, were shown as prognostic factors for survival, while in the multivariate analysis, only the pN of the primary tumor and the presence of ovarian metastasis were proven to be the most important. Although these factors influence the survival of PMCRC patients, the resectability of the metastasis should be only dependent on factors that prevent their resectability (operability); although on patients with these factors, a closer follow-up should be considered. In any case, larger prospective studies are required to confirm these results.