The surgical treatment of patients with isolated colorectal hepatic- or pulmonary metastases is well established with a 5-year survival in the range of 40–50 %. In contrast the treatment of patients with both hepatic- and pulmonary metastases remains controversial. We here present our initial results of patients who underwent both hepatic- and pulmonary resections for colorectal metastases with emphasis on post-operative complications and long-term survival.
The files of patients with metastasising colorectal cancer who underwent both hepatic- and pulmonary metastasectomy during 2003–2010 were reviewed retrospectively. Estimated overall survival and 1-, 3-, and 5-year survival rates were calculated by the method of Kaplan Meier. The log-rank test was used to compare patients survival for synchronous and metachronous metastases. A p value < 0.05 was considered significant.
Nineteen patients were identified (9F/10M) with a median age of 63 years. Ten patients (53 %) presented with synchronous metastases and nine patients (47 %) with metachronous metastases. Only minor medical- and surgical complications were reported subsequent surgery. The 30-day mortality was zero. From time of resection of the primary colorectal tumour the estimated 5-year survival rate was 48.5 % with a median survival of 47 months. There were no difference in long-term survival between synchronous and metachronous metastases (p> 0.05).
The present study has demonstrated that resection of both hepatic and pulmonary colorectal metastases is safe and good long-term outcome can be obtained for selected patients. Thus, an aggressive surgical approach to patients with synchronous or metachronous hepatic and pulmonary metastases seems justified.