J.Jpn. Surg. Soc.. 90(1): 75-81, 1989

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Original article

SURGICAL TREATMENT FOR PULMONARY METASTASES OF COLORECTAL CANCER

From 1962 to 1987, 72 patients with primary colorectal cancer underwent surgical treatment forpulmonary metastases. The overall cumulative 5 year survival rate was 41.3%. But the cumulative 1 year survival rate of patients with incomplete resectin was 20.0%. Reduction surgery should not beemployed.
Twenty-nine of 66 patients with complete resectin have recurred. The most of first manifestedrecurrences were in the lung and within 18 months after thoracotomy. This tendency was remarkablein patients with multiple pulmonary metastases and all recurrences of them were within 18 months and 80% were multiple in bilateral lung. Almost all multiple pulmonary metastases seemed to be only onemanifestation of generalized metastatic disease. So indication of surgical treatment for them should becautious.
Type of pulmonary resection had no influence on post-thoracotomy survival rate. But in patientswith partial resection, 7 recurrences at surgical margin and one recurrence on regional lymph nodes weredoubted. Four metastatic lesions less than 3cm in maximum diarneter had metastases to the regionallymph nodes. To resect more curatively, lobectomy and systemic lymphadenectomy should be recommended as the standard operation for pulmonary metastases of colorectal cancer.

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