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Benefit of Adjuvant Chemotherapy After Curative Resection of Lung Metastasis in Colorectal Cancer

 Hyung Soon Park  ;  Minkyu Jung  ;  Sang Joon Shin  ;  Su Jin Heo  ;  Chang Gon Kim  ;  Min Goo Lee  ;  Seung Hoon Beom  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Joong Bae Ahn 
 Annals of Surgical Oncology, Vol.23(3) : 928-935, 2016 
Journal Title
 Annals of Surgical Oncology 
Issue Date
Adenocarcinoma/drug therapy* ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemotherapy, Adjuvant ; Colorectal Neoplasms/drug therapy* ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/drug therapy* ; Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Lymphatic Metastasis ; Male ; Metastasectomy* ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy* ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Pneumonectomy ; Prognosis ; Survival Rate
Overall Survival ; Liver Metastasis ; Adjuvant Chemotherapy ; Lung Metastasis ; National Comprehensive Cancer Network
BACKGROUND: The survival benefit of adjuvant chemotherapy after colorectal cancer (CRC) lung metastasectomy is uncertain. METHODS: We enrolled 221 CRC patients who underwent pulmonary metastasectomy between October 2002 and July 2013, including those with previous liver metastasis that had been curatively resected. Disease-free survival (DFS) and overall survival (OS) were calculated from the day of lung metastasectomy. RESULTS: Among all patients, 176 (79.6%) received adjuvant chemotherapy after lung metastasectomy. Median follow-up was 34.7 months from the time of lung metastasectomy [95% confidence interval (95% CI), 7.4-90.9 months]. Patients treated with adjuvant chemotherapy had longer DFS compared with surgery alone (median 32.7 vs 11.2 months respectively, P = 0.076). Multivariate analysis revealed previous liver metastasis, preoperative carcinoembryonic antigen ≥5 ng/mL, disease-free interval <24 months, and surgery without adjuvant chemotherapy as independent risk factors for recurrence. Low-risk patients who had 0-1 risk factors received a significant survival benefit from adjuvant chemotherapy [hazard ratio (HR) 0.54; 95% CI 0.32-0.91, P = 0.020]; however, high-risk patients with ≥2 risk factors did not (HR 1.02; 95% CI 0.48-2.14, P = 0.964). Patients treated with adjuvant chemotherapy showed no OS benefit compared with patients who received surgery alone (median 89.6 vs 86.8 months respectively, P = 0.833). CONCLUSIONS: CRC patients received lung metastasectomy could have a DFS benefit from adjuvant chemotherapy, especially in low-risk patients. Larger, prospective studies are needed to evaluate the role of adjuvant chemotherapy after CRC lung metastasectomy.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, Hyung Soon(박형순)
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Lee, Min Goo(이민구) ORCID logo https://orcid.org/0000-0001-7436-012X
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Heo, Su Jin(허수진) ORCID logo https://orcid.org/0000-0002-0615-5869
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