Hofmann HS, Doblinger C, Szöke T, Grosser C, Potzger T, Ried M, Neu R. [Influence of primary lymph node status of colorectal cancer on the development of pulmonary metastases and thoracic lymph node metastases].
Chirurg 2018;
90:403-410. [PMID:
30276427 DOI:
10.1007/s00104-018-0742-y]
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Abstract
BACKGROUND
The lungs are the second most common organ site for metastases in patients with colorectal cancer (CRC). Lymph node metastasis of CRC represents a prognostic factor for survival.
OBJECTIVE
The present study investigated the influence of CRC lymph node metastasis on lung metastasis, in particular thoracic lymph node metastasis.
MATERIAL AND METHODS
A retrospective analysis of 88 patients (n = 56 male) with curative resection of lung metastases of CRC was performed. Primary endpoint: influence of lymph node status of CRC on lung metastases. Secondary endpoints: disease-free survival and overall survival. Statistical evaluation was carried out with SPSS.
RESULTS
In 48 patients a positive lymph node status of CRC and in 9 patients an N+ status of lung metastases were determined. The lymph node status of the CRC significantly affected the incidence of synchronous metastases (p = 0.03), disease-free interval until formation of metachronous lung metastases (p = 0.012) and the overall survival of patients with CRC (p = 0.048). The 5‑year survival rate for CRC patients with lung metastases was 48.7% after pulmonary metastasectomy. Thoracic lymph node involvement also significantly affected survival (p = 0.001).
CONCLUSION
Screening for pulmonary metastases should be included in the staging and follow-up of all patients with CRC, especially in patients with a positive lymph node status of the CRC.
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