Effectiveness of uniportal video-assisted thoracoscopic sublobar resection and lobectomy for lung metastases from colorectal cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Wei ¹ , ZHANG Ni ² ,  LIU Changyu ²

1. Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, P.R.China;
2. Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R.China;

Corresponding author：

LIU Changyu, Email: liuchangyu0508@gmail.com

Keywords：

Colorectal cancer; lung metastases; sublobar resection; lobectomy; uniportal video-assisted thoracoscopic surgery

DOI：

10.7507/1007-4848.202008003

Video：

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Objective To investigate the effectiveness of sublobar resection and lobectomy via uniportal video-assisted thoracoscopic surgery (U-VATS) for lung metastases from colorectal cancer.Methods Retrospective research was conducted on 42 colorectal cancer patients with lung metastases who underwent U-VATS sublobar resection and lobectomy at the Tongji Hospital, Huazhong University of Science and Technology between April 2016 and May 2019, including 24 males and 18 females with an average age of 58.0±9.9 years. Among them 17 patients received U-VATS sublobar resection and 25 patients received lobectomy. The operation time, intraoperative blood loss, postoperative pulmonary infection, drainage tube indwelling time, drainage volume on the first day after surgery, postoperative hospital stay were analyzed between the two groups, and the relationship between the prognosis and clinical characteristics of the two groups was compared.Results Sublobar resection patients had less lung metastases (P=0.043) and shorter operation time (P=0.023) compared with the lobectomy patients. There was no significant difference between the lobectomy and sublobar resection groups in intraoperative blood loss (P=0.169), rate of postoperative infection (P=0.982), postoperative drainage duration (P=0.265), drainage volume on the first day after surgery (P=0.402) and postoperative hospital stay (P=0.612). The progression-free survival of the two groups was 25.19 months and 23.63 months (P=0.721), and their overall survival was 29.09 months and 30.64 months (P=0.554).Conclusion Considering guantity and locations of lung metastases, U-VATS sublobar resection can achieve a similar prognosis to lobectomy for lung metastases from colorectal cancer. Further efficacy of this surgical strategy remains to be proved by longer follow-up.

Citation： WU Wei, ZHANG Ni, LIU Changyu. Effectiveness of uniportal video-assisted thoracoscopic sublobar resection and lobectomy for lung metastases from colorectal cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(5): 540-544. doi: 10.7507/1007-4848.202008003 Copy

1.	McCormack PM, Martini N. The changing role of surgery for pulmonary metastases. Ann Thorac Surg, 1979, 28(2): 139-145.
2.	沈建飞, 杨成林, 何建行. 肺转移瘤的外科治疗进展. 临床与病理杂志, 2015, 35(1): 106-110.
3.	Mitry E, Guiu B, Cosconea S, et al. Epidemiology, management and prognosis of colorectal cancer with lung metastases: A 30-year population-based study. Gut, 2010, 59(10): 1383-1388.
4.	Tampellini M, Ottone A, Bellini E, et al. The role of lung metastasis resection in improving outcome of colorectal cancer patients: Results from a large retrospective study. Oncologist, 2012, 17(11): 1430-1438.
5.	Bartlett EK, Simmons KD, Wachtel H, et al. The rise in metastasectomy across cancer types over the past decade. Cancer, 2015, 121(5): 747-757.
6.	中国医师协会外科医师分会多学科综合治疗专业委员会, 中国抗癌协会大肠癌专业委员会. 结直肠癌肺转移多学科综合治疗专家共识(2018版). 中华结直肠疾病电子杂志, 2018, 7(6): 502-509.
7.	Han D, Cao Y, Wu H, et al. Uniportal video-assisted thoracic surgery for the treatment of lung cancer: A consensus report from Chinese Society for Thoracic and Cardiovascular Surgery (CSTCVS) and Chinese Association of Thoracic Surgeons (CATS). Transl Lung Cancer Res, 2020, 9(4): 971-987.
8.	Treasure T, Milošević M, Fiorentino F, et al. Pulmonary metastasectomy: What is the practice and where is the evidence for effectiveness? Thorax, 2014, 69(10): 946-949.
9.	Royal Brompton & Harefield NHS Foundation Trust, University of Cambridge, University of Sussex. A randomised trial of pulmonary metastasectomy in colorectal cancer (PulMiCC). https://clinicaltrials.gov/ct2/show/NCT01106261.
10.	Prasanna T, Karapetis CS, Roder D, et al. The survival outcome of patients with metastatic colorectal cancer based on the site of metastases and the impact of molecular markers and site of primary cancer on metastatic pattern. Acta Oncol, 2018, 57(11): 1438-1444.
11.	Erhunmwunsee L, Tong BC. Preoperative evaluation and indications for pulmonary metastasectomy. Thorac Surg Clin, 2016, 26(1): 7-12.
12.	Cho S, Song IH, Yang HC, et al. Prognostic factors of pulmonary metastasis from colorectal carcinoma. Interact Cardiovasc Thorac Surg, 2013, 17(2): 303-307.
13.	Bölükbas S, Sponholz S, Kudelin N, et al. Risk factors for lymph node metastases and prognosticators of survival in patients undergoing pulmonary metastasectomy for colorectal cancer. Ann Thorac Surg, 2014, 97(6): 1926-1932.
14.	Gonzalez M, Poncet A, Combescure C, et al. Risk factors for survival after lung metastasectomy in colorectal cancer patients: A systematic review and meta-analysis. Ann Surg Oncol, 2013, 20(2): 572-579.
15.	Simms L, Barraclough H, Govindan R. Biostatistics primer: What a clinician ought to know—prognostic and predictive factors. J Thorac Oncol, 2013, 8(6): 808-813.
16.	Embun R, Rivas de Andrés JJ, Call S, et al. Causal model of survival after pulmonary metastasectomy of colorectal cancer: A nationwide prospective registry. Ann Thorac Surg, 2016, 101(5): 1883-1890.
17.	Nakamura H, Kawasaki N, Taguchi M, et al. Survival following lobectomy vs limited resection for stage Ⅰ lung cancer: A meta-analysis. Br J Cancer, 2005, 92(6): 1033-1037.
18.	Zhang Y, Sun Y, Wang R, et al. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stage Ⅰ non-small cell lung cancer. J Surg Oncol, 2015, 111(3): 334-340.
19.	Vogelsang H, Haas S, Hierholzer C, et al. Factors influencing survival after resection of pulmonary metastases from colorectal cancer. Br J Surg, 2004, 91(8): 1066-1071.

1. McCormack PM, Martini N. The changing role of surgery for pulmonary metastases. Ann Thorac Surg, 1979, 28(2): 139-145.
2. 沈建飞, 杨成林, 何建行. 肺转移瘤的外科治疗进展. 临床与病理杂志, 2015, 35(1): 106-110.
3. Mitry E, Guiu B, Cosconea S, et al. Epidemiology, management and prognosis of colorectal cancer with lung metastases: A 30-year population-based study. Gut, 2010, 59(10): 1383-1388.
4. Tampellini M, Ottone A, Bellini E, et al. The role of lung metastasis resection in improving outcome of colorectal cancer patients: Results from a large retrospective study. Oncologist, 2012, 17(11): 1430-1438.
5. Bartlett EK, Simmons KD, Wachtel H, et al. The rise in metastasectomy across cancer types over the past decade. Cancer, 2015, 121(5): 747-757.
6. 中国医师协会外科医师分会多学科综合治疗专业委员会, 中国抗癌协会大肠癌专业委员会. 结直肠癌肺转移多学科综合治疗专家共识(2018版). 中华结直肠疾病电子杂志, 2018, 7(6): 502-509.
7. Han D, Cao Y, Wu H, et al. Uniportal video-assisted thoracic surgery for the treatment of lung cancer: A consensus report from Chinese Society for Thoracic and Cardiovascular Surgery (CSTCVS) and Chinese Association of Thoracic Surgeons (CATS). Transl Lung Cancer Res, 2020, 9(4): 971-987.
8. Treasure T, Milošević M, Fiorentino F, et al. Pulmonary metastasectomy: What is the practice and where is the evidence for effectiveness? Thorax, 2014, 69(10): 946-949.
9. Royal Brompton & Harefield NHS Foundation Trust, University of Cambridge, University of Sussex. A randomised trial of pulmonary metastasectomy in colorectal cancer (PulMiCC). https://clinicaltrials.gov/ct2/show/NCT01106261.
10. Prasanna T, Karapetis CS, Roder D, et al. The survival outcome of patients with metastatic colorectal cancer based on the site of metastases and the impact of molecular markers and site of primary cancer on metastatic pattern. Acta Oncol, 2018, 57(11): 1438-1444.
11. Erhunmwunsee L, Tong BC. Preoperative evaluation and indications for pulmonary metastasectomy. Thorac Surg Clin, 2016, 26(1): 7-12.
12. Cho S, Song IH, Yang HC, et al. Prognostic factors of pulmonary metastasis from colorectal carcinoma. Interact Cardiovasc Thorac Surg, 2013, 17(2): 303-307.
13. Bölükbas S, Sponholz S, Kudelin N, et al. Risk factors for lymph node metastases and prognosticators of survival in patients undergoing pulmonary metastasectomy for colorectal cancer. Ann Thorac Surg, 2014, 97(6): 1926-1932.
14. Gonzalez M, Poncet A, Combescure C, et al. Risk factors for survival after lung metastasectomy in colorectal cancer patients: A systematic review and meta-analysis. Ann Surg Oncol, 2013, 20(2): 572-579.
15. Simms L, Barraclough H, Govindan R. Biostatistics primer: What a clinician ought to know—prognostic and predictive factors. J Thorac Oncol, 2013, 8(6): 808-813.
16. Embun R, Rivas de Andrés JJ, Call S, et al. Causal model of survival after pulmonary metastasectomy of colorectal cancer: A nationwide prospective registry. Ann Thorac Surg, 2016, 101(5): 1883-1890.
17. Nakamura H, Kawasaki N, Taguchi M, et al. Survival following lobectomy vs limited resection for stage Ⅰ lung cancer: A meta-analysis. Br J Cancer, 2005, 92(6): 1033-1037.
18. Zhang Y, Sun Y, Wang R, et al. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stage Ⅰ non-small cell lung cancer. J Surg Oncol, 2015, 111(3): 334-340.
19. Vogelsang H, Haas S, Hierholzer C, et al. Factors influencing survival after resection of pulmonary metastases from colorectal cancer. Br J Surg, 2004, 91(8): 1066-1071.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effectiveness of uniportal video-assisted thoracoscopic sublobar resection and lobectomy for lung metastases from colorectal cancer

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