Objective To investigate prognostic factors of surgery treatment for pulmonary metastasis from rectal cancer. Methods From September 1973 to September 2007,43 patients, 12 women and 31 men with mean age of 58 years (ranged 36-77 years) were diagnosed and performed 45 curative resections of pulmonary metastases from rectal cancer in this hospital.Followup informations were collected including：the clinical parameters include age, sex, pTNM/UICC stage,the number, maximum diameter of lung metastases，the preoperative serum carcinoembryonic antigen(CEA) levels, the interval between resection of primary tumor and diagnosis of lung metastasis (disease-free interval (DFI)，the presence of hilar/mediastinal tumorinfiltrated lymph nodes，intraoperative blood loss and postoperative chemotherapy schemes. After lung metastasectomy，probability of survival was calculated according to the method of KaplanMeier.All factors that may have affected the survival were entered into Cox’s proportional hazards regression model to identify significant variables associated with survival. Results Fourty-three patients were selected fully follow-up cases, with mean period ranged from 1-103 months (median 54 months). There was 1 early postoperative mortality from cardiac complications (2.3%). The probability of survival at 1, 3, and 5 years was 91.3％，56.4% and 32.2%, respectively，Median overall survival was 42.6 months. The DFI was found to be 28.6 months（ranged 0-114 months）. Hilar or mediastinal tumorinvolved
lymph nodes were found in 9 patients. Fiveyear survival was 42.6% for patients with CEA＜5ng／ml and 18.0% for those with CEA≥5ng／ml (P=0.009).Fiveyear survival rate was 53.3% for patients with DFI≥3 years, 32.3% for those with1 year＜DFI＜3 years and 15.1% for those with DFI ≤1 year (P=0.036). In the multivariate analysis,the overall survival was significantly correlated with the preoperative serum CEA level and DFI (P=0.013,0.016),respectively. Conclusion Patients with pulmonary metastases from colorectal carcinoma will benefit from pulmonary metastasectomy. Patients with preoperative serum CEA ＜5ng／ml and DFI ≥3 years have an significantly long-term survival.

Citation： WANG Hao,JIANG Gening,ZHANG Peng,et al .. Surgical Treatment for Pulmonary Metastases from Rectal Cancer:Factors Influencing Prognosis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2009, 16(1): 22-26. doi: Copy