Surgical resection of pulmonary metastases from colorectal carcinoma

Between 1986 and 1994, 19 patients underwent pulmonary re- section for metastatic colorectal car- cinoma. T he mean interval between colon resection and appearance of pulmonary metastasis was 41 + 21 months. All the patients had no more than two metastases. "Wedge resec- tion alone or associated with lobec- tomy was performed in four patients, lobectomy in ten, and pneumonec- tomy in five. One patient died within the month after surgery. Mean fol- low-up was 35 _+ 26 months. The 5-year survival rate was 38.7%. Re- peat thoracotomy for recurrent me- tastases was performed in one pa- tient. The disease-free interval, the size of metastases, the type of pul- monary resection, and the location and the stage of primary cancer had no apparent influence on survival, but the survival rate at 4 years was 25% for patients with high carcin- oembryonic antigen (CEA) level ver- sus 80% for those with low CEA level. We conclude that, at least when the number of metastases is less than two, resection of colorectal lung metastasis is safe and effective. (Enr J Cardio-thorac Surg (1996) 10: 347-351)