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Ann Thorac Surg 2006;81:2008-2013
© 2006 The Society of Thoracic Surgeons

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Original article: General thoracic

Prognostic Factors and Analysis of Microsatellite Instability in Resected Pulmonary Metastases From Colorectal Carcinoma

^a Department of Thoracic Surgery, Scientific Institute H San Raffaele, Milan, Italy
^b Department of Pathology, Scientific Institute H San Raffaele, Milan, Italy

Accepted for publication January 3, 2006.

^_* Address correspondence to Dr Melloni, Unità Operativa di Chirurgia Toracica, Ospedale San Raffaele, Via Olgettina 60, Milan 20132, Italy (Email: giulio.melloni{at}hsr.it).

BACKGROUND: In this study, we analyze our experience with pulmonary resection for metastases from colorectal carcinoma. The aims were to search for factors influencing prognosis and to investigate the presence of microsatellite instability in the primary tumors and the corresponding lung metastases.

METHODS: We identified 81 patients who underwent surgical resection between 1991 and 2004. The microsatellite instability was determined by immunohistochemical evaluation of MSH2 and MLH1 in 117 lesions (41 primary tumors and 76 lung metastases).

RESULTS: Overall 3-, 5-, and 10-year survival rates were 50%, 42%, and 30%, respectively. Univariate analysis showed that stage of the primary tumor (p = 0.037), radicalness of the resection (p = 0.019), and stratification into groups according to the International Registry of Lung Metastases classification (p = 0.039) were prognostic factors. Multivariate analysis showed that stage of the primary tumor (p = 0.030) and the radicalness of the resection (p = 0.014) were independent prognostic factors. All tumors displayed preserved expression of MSH2 and MLH1 and were considered microsatellite stable lesions.

CONCLUSIONS: Pulmonary resection of metastases from colorectal carcinoma results in long-term survival in selected patients. Complete resection, stage of the primary tumor and stratification into groups according to the International Registry of Lung Metastases classification were prognostic factors. All the metastases and the corresponding primary tumors were microsatellite stable lesions. This finding seems to demonstrate that pulmonary metastases are infrequent in colorectal carcinomas with microsatellite instability.

This article has been cited by other articles:

				J. Pfannschmidt, H. Dienemann, and H. Hoffmann Surgical Resection of Pulmonary Metastases From Colorectal Cancer: A Systematic Review of Published Series Ann. Thorac. Surg., July 1, 2007; 84(1): 324 - 338. [Abstract] [Full Text] [PDF]