Impact of Liver and Primary Tumor Localization on Survival in Lung Metastasectomy for Colorectal Carcinoma

TL;DR

This study shows that the location of the primary colorectal tumor and the absence of nodal metastasis significantly affect survival after lung metastasectomy.

Contribution

The study clarifies the conflicting evidence on how primary tumor location affects survival after lung metastasectomy for colorectal cancer.

Findings

Right-sided colon tumors were associated with worse DFS and OS compared to left-sided and rectal tumors.

Patients with no nodal metastasis had significantly better DFS and OS.

Elevated CEA levels were linked to improved OS but not DFS.

Abstract

Despite the knowledge that right-sided colon tumors are associated with worse overall survival (OS) and disease-free survival (DFS) compared to left-sided and rectal tumors, there are conflicting results on the impact of the primary location of colorectal tumors after lung metastasectomy. In this study, we aimed to investigate this contradiction.

We conducted a retrospective analysis of 131 patients who underwent lung metastasectomy for colorectal cancer. DFS and OS were evaluated in relation to primary tumor location, liver metastasis, lymph node dissection, nodal status, and carcinoembryonic antigen (CEA) levels.

Among patients with no nodal metastasis (N0), significantly better DFS (p = 0.024) and OS (p = 0.030) were observed. Elevated CEA levels were not associated with DFS but were linked to improved OS (p = 0.004). Right-sided colon tumors were associated with worse DFS and OS compared to left-sided and rectal tumors (p <0.002 and p <0.001, respectively).

Right-sided colon tumors were associated with the poorest DFS and OS, underscoring the prognostic significance of primary tumor location. Additionally, the absence of nodal metastasis was associated with significantly improved survival outcomes. Liver metastasis was not significantly associated with DFS or OS.

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