Results of a pulmonary metastasectomy in patients with colorectal cancer
ABSTRACT The lung is one of the key sites of hematogenous metastasis in patients with colorectal cancer. A metastasectomy of the lung is reported to improve the prognosis of colorectal cancer. We reviewed our experience in evaluating the surgical outcomes in colorectal cancer patients who have undergone a pulmonary metastasectomy.
A single-center retrospective evaluation of clinical prognostic factors (1996-2008) related to a pulmonary metastasectomy of patients with colorectal cancer was conducted. Fifty-seven consecutive patients in our hospital who had undergone a resection of pulmonary metastasis from colorectal cancer were retrospectively investigated.
The mean age of the patients who underwent an initial pulmonary metastasectomy was 63.8 years. The average number of pulmonary metastases was 3.8. Pulmonary metastasectomy was performed an average of 1.6 times per head. A total of 32 patients had undergone a liver metastasectomy, and the 5-year survival of these 32 patients was 43.1%. The 5-year survival of the time from first pulmonary metastasectomy was 53.9%. There were no statistical differences with regard to the disease-free interval, interval from primary resection, or the number of pulmonary metastasectomies.
A pulmonary resection for colorectal pulmonary metastases is therefore considered to be a favorable treatment for long-term survival even in the presence of liver metastases. Thoracic surgeons should therefore aggressively perform a pulmonary metastasectomy of colorectal cancer.
Conference Paper: Source number estimator using Gerschgorin disks[Show abstract] [Hide abstract]
ABSTRACT: The eigenstructure based estimator designed to be used with the aid of the Gerschgorin's disk theorem is proposed for source number detection. By introducing the unitary transformation of the covariance matrix, the Gerschgorin radii of the eigenstructure are exploited to determine the number of sources while overcoming a lack of data samples, noise model and data independency information. Unlike conventional methods such as Akaike information criterion (AIC) and minimum descriptive length criterion (MDL), which are based on the cluster analysis of the eigenvalues used in conjunction with statistical formulations, the proposed method called the Gerschgorin disk estimator (GDE), provide more accurate detection of the source number in situations of both simulated and measured experimental dataAcoustics, Speech, and Signal Processing, 1994. ICASSP-94., 1994 IEEE International Conference on; 05/1994
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ABSTRACT: To investigate the expression status and clinical implications of stem cell genes CD133 and CD44 in the colorectal cancers with early liver metastasis. The differential genes of early liver metastases in colorectal cancer were detected by RT(2) Profiler™ PCR Array. The expression and the relationship of stem cell gene CD133 and CD44 were analyzed by immunofluorescent tests. CD133 and CD44 were significantly higher co-expressed in colorectal cancer with early liver metastases compared to those without early liver metastases, and the content of CD133 and CD44 proteins decreased following growth of the transplanted tumors. Of the 80 cases without early liver metastases, 12 were observed CD133 and CD44 proteins co-expression, while 36 of the 40 cases with early liver metastases were found CD133 and CD44 proteins co-expression (15% vs. 90%, P < 0.05). Survival analysis revealed CD133 and CD44 proteins co-expression was associated with poorest prognosis (57.14% vs. 87.41%, X(2) = 48.49, P = 0.001). After Cox regression, age, Duck's stage, lymph node metastasis, and CD133 and CD44 proteins co-expression were shown to be the independent prognostic factors of colorectal cancers. CD133 and CD44 proteins were highly co-expressed in colorectal cancer with early liver metastases, and may be a potential biomarker for the early liver metastases.Surgical Oncology 07/2011; 21(2):103-7. DOI:10.1016/j.suronc.2011.06.001 · 2.37 Impact Factor
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ABSTRACT: Resection of lung metastases from colorectal cancer (CRC) is increasingly performed with a curative intent. This strategy was made possible in the 1990s by the development of new chemotherapeutic approaches, improved surgical techniques and better imaging modalities. However, evidence-based data showing clinical benefits of lung metastasectomy in this setting are nonexistent, and there are no prospective randomized trials to support the routine performance of these procedures for stage IV CRC. Current evidence suggests that resection of pulmonary metastases in combination with new cytotoxic agents, such as oxaliplatin, irinotecan and bevacizumab, may result in prolonged survival for many, and cure for a small minority of CRC patients who experienced tumor spread beyond the limits of the abdomen. This review focuses on the results of surgical management of CRC patients with lung metastases: we report the outcome of published series according to the presence or the absence of liver metastasis (and hepatic resection) prior to lung resection.Expert Review of Anti-infective Therapy 04/2012; 12(4):495-503. DOI:10.1586/era.12.21 · 2.28 Impact Factor