Sequential hepatic and pulmonary resections for metastatic colorectal cancer

Abstract

Background: Resection of pulmonary or hepatic colorectal metastases is associated with a 5-year survival rate of 25–40 per cent. This report analyses outcome following sequential resection of colorectal metastases to both organs. Methods: Seventeen patients with histologically confirmed colorectal adenocarcinoma and resection of liver and lung metastases were identified from a prospective database. Results: The median interval between resection of the primary tumour and first metastasis was 21 (range 0–64) months. The interval between resection of the first and subsequent metastases was 18 (range 1–74) months. No patient died in the postoperative period and there were two perioperative complications. The overall survival rate in 17 patients was 70 per cent at 2 years from resection of metastasis to the second organ, but the disease-free survival rate at 2 years was only 24 per cent. Conclusion: Although few long-term survivors were observed in this small series, sequential resection of hepatic and pulmonary metastases is warranted in a highly selected group of patients.