https://orcid.org/0000-0003-1182-4083
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Abstract
Purpose
This study aimed to evaluate the role of anatomical resection (AR) in lung metastasectomy (LM) of colorectal cancer (CRC) and to investigate clinically relevant prognostic factors.
Patients and Methods
The medical records of 350 consecutive patients who underwent LM of CRC from 2011 to 2019 were reviewed. The patients were designated into AR group (lobectomy and segmentectomy), and non-anatomical resection (NAR) group (wedge resection), respectively. Kaplan–Meier method was used to analyze disease-free survival (DFS), pulmonary-specific disease-free survival (PDFS) and overall survival (OS). Cox proportional hazards regression model was performed to analyze the factors associated with DFS, PDFS and OS.
Results
A total of 92 (31.2%) patients were enrolled in AR group and 203 (68.8%) in non-anatomical resection (NAR) group. AR significantly improved the 3-year DFS (64.1% vs 46.8%, HR 0.587, 95% CI 0.397–0.867, P = 0.007) and PDFS (75.0% vs 60.1%, HR 0.565, 95% CI 0.356–0.899, P = 0.016) compared with NAR. However, the extent of resection did not significantly impact the 3-year OS (AR 92.4% vs NAR 85.7%, HR 0.511, 95% CI 0.224–1.165, P = 0.110). In multivariate analysis, AR was identified as a protective factor for DFS (HR 0.576, 95% CI 0.356–0.934, P = 0.025) and PDFS (HR 0.631, 95% CI 0.409–0.973, P = 0.037). Preoperative abnormal CA19-9 was identified as the only prognostic factor for OS.
Conclusion
AR was superior to NAR for DFS and PDFS after LM from CRC.
Acknowledgments
This study was funded by the National Natural Science Foundation of China (82072678, 81602035, 81472228); Shanghai Science and Technology Committee Project (19511121301, 18140903200); Clinical Research Plan of SHDC (SHDC2020CR5006, SHDC2020CR1033B, SHDC2020CR3037B); Youth Science Fund of Zhongshan Hospital (2019ZSQN28).
Disclosure
There was no financial and personal relationship with other people and organizations that could inappropriately influence this work. The authors report no conflicts of interest in this work.