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Hammoud D, Glorion M, Genova P, El Hajjam M, Assouad J, Peschaud F, Neuzillet C, Debrosse D, Lupinacci RM. Contemporary Outcomes for the Curative Treatment of Colorectal Cancer Pulmonary Metastases. J Gastrointest Cancer 2023; 54:1185-1192. [PMID: 36595103 DOI: 10.1007/s12029-022-00908-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Treatment of pulmonary metastases (PM) from colorectal cancer (CRC) is the standard of care by several guidelines from Europe and the USA, but the validity of this strategy has been recently questioned, and the available evidence supporting this strategy is weak. We report the outcomes of a curative intent strategy in a very recent and homogenous series of patients. METHODS We did a retrospective review of all curative intent surgical or ablative treatment of PM from CRC performed consecutively in 3 French institutions from January 2015 to December 2019. Demographics, clinicopathological, and molecular characteristics were evaluated. Cox regression models were used to identify prognostic factors related to local recurrence and disease-free survival. RESULTS Records from 152 patients were reviewed. One-hundred thirty-five patients (88%) had surgical metastasectomy. Median age was 67 years. Most of the patients had a single lesion (66%), and 16% had synchronous PM. Eighty-one patients (53%) experienced recurrence, and the thorax was the most common site of recurrence. Median disease-free survival and overall survival were 35 months and 78 months after PM treatment. At the end of the study, only 17% of the patients died. Pulmonary tumor burden was correlated with disease-free survival in univariate analysis, but multivariate analysis did not find any prognostic factor independently associated with local recurrence or survival. CONCLUSION Our finds corroborate existing recommendation for the invasive treatment of PM from CRC in selected patients.
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Affiliation(s)
- Dima Hammoud
- Department of Digestive and Oncologic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, 9 Avenue Charles de Gaulle, 92104, Boulogne-Billancourt, France
| | - Matthieu Glorion
- Department of Thoracic Surgery and Lung Transplantation, Foch Hospital, Suresnes, France
| | - Pietro Genova
- Department of Digestive and Oncologic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, 9 Avenue Charles de Gaulle, 92104, Boulogne-Billancourt, France
| | - Mostapha El Hajjam
- Department of Digestive and Oncologic Surgery, Université Paris-Saclay, Université de Versailles SQY (UVSQ), Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, EA4340-BECCOH, Boulogne-Billancourt, France
- Department of Radiology, Université Paris-Saclay, Université de Versailles SQY (UVSQ), Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, Boulogne-Billancourt, France
| | - Jalal Assouad
- Department of Thoracic Surgery, Tenon University Hospital, Paris, France
| | - Frédérique Peschaud
- Department of Digestive and Oncologic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, 9 Avenue Charles de Gaulle, 92104, Boulogne-Billancourt, France
- Department of Digestive and Oncologic Surgery, Université Paris-Saclay, Université de Versailles SQY (UVSQ), Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, EA4340-BECCOH, Boulogne-Billancourt, France
| | - Cindy Neuzillet
- Institut Curie, Versailles Saint-Quentin University - Paris Saclay University, Saint-Cloud, France
| | - Denis Debrosse
- Department of Thoracic Surgery, Tenon University Hospital, Paris, France
| | - Renato Micelli Lupinacci
- Department of Digestive and Oncologic Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, 9 Avenue Charles de Gaulle, 92104, Boulogne-Billancourt, France.
- Department of Digestive and Oncologic Surgery, Université Paris-Saclay, Université de Versailles SQY (UVSQ), Assistance Publique-Hôpitaux de Paris (AP-HP), Ambroise-Paré Hospital, EA4340-BECCOH, Boulogne-Billancourt, France.
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van den Broek JJ, van Gestel T, Kol SQ, van Geel AM, Geenen RWF, Schreurs WH. Dealing with indeterminate pulmonary nodules in colorectal cancer patients; a systematic review. Eur J Surg Oncol 2021; 47:2749-2756. [PMID: 34119380 DOI: 10.1016/j.ejso.2021.05.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/29/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Indeterminate pulmonary nodules (IPNs) are frequently encountered on staging computed tomography (CT) in colorectal cancer (CRC) patients and they create diagnostic dilemmas. This systematic review and pooled analysis aims to estimate the incidence and risk of malignancy of IPNs and provide an overview of the existing literature on IPNs in CRC patients. MATERIALS AND METHODS EMBASE, Pubmed and the Cochrane database were searched for papers published between January 2005 and April 2020. Studies describing the incidence of IPNs and the risk of malignancy in CRC patients and where the full text was available in the English language were considered for inclusion. Exclusion criteria included studies that used chest X-ray instead of CT, liver metastasis cohorts, studies with less than 60 CRC patients and reviews. RESULTS A total of 18 studies met the inclusion criteria, involving 8637 patients. Pooled analysis revealed IPNs on staging chest CT in 1327 (15%) of the CRC patients. IPNs appeared to be metastatic disease during follow up in 16% of these patients. Regional lymph node metastases, liver metastases, location of the primary tumour in the rectum, larger IPN size and multiple IPNs are the five most frequently reported parameters predicting the risk of malignancy of IPNs. CONCLUSION A risk stratification model for CRC patients with IPNs is warranted to enable an adequate selection of high risk patients for IPN follow up and to diminish the use of unnecessary repetitive chest CT-scans in the many low risk patients.
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Affiliation(s)
- Joris J van den Broek
- Department of Surgery, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands.
| | - Tess van Gestel
- Department of Surgery, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands
| | - Sabrine Q Kol
- Department of Radiology, AUMC, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Anne M van Geel
- Department of Radiology, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands
| | - Wilhelmina H Schreurs
- Department of Surgery, Northwest Clinics, PO Box 501, 1815 JD, Alkmaar, the Netherlands
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van Dorp M, Heineman DJ, Steup WH, Schreurs WH. Reply to Milosevic et al. Eur J Cardiothorac Surg 2020; 59:ezaa293. [PMID: 33006595 DOI: 10.1093/ejcts/ezaa293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 01/31/2023] Open
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