Clinical significance of subcentimeter pulmonary nodules in patients undergoing hepatectomy for colorectal liver metastases.
colorectal liver metastases
hepatectomy
subcentimeter pulmonary nodules
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
25
03
2020
revised:
05
05
2020
accepted:
09
05
2020
pubmed:
20
6
2020
medline:
20
8
2020
entrez:
20
6
2020
Statut:
ppublish
Résumé
The clinical significance of lung metastases regarded as subcentimeter pulmonary nodules (SPN) before hepatectomy for colorectal liver metastases (CLM) has not been assessed well. The data from 569 patients undergoing hepatectomy for CLM from 2010 to 2016 were reviewed. The presence and final diagnosis of SPN were analyzed for their association with overall survival (OS). A total of 143 patients had SPN (25.1%). SPN were proved to be lung metastases in 43 patients (30.1%). Before hepatectomy, lung metastases were suspected in 25 patients (sensitivity: 58%; specificity: 100%). The 5-year OS of patients with lung metastases (45.4%) was worse than that of those with no pulmonary nodules (60.9%, P = .003). There was no significant difference in the 5-year OS between the patients with lung metastases diagnosed after hepatectomy (48.7%) and before hepatectomy (41.2%, P = .432). The 5-year OS of patients who underwent surgery for lung metastases after hepatectomy (60.5%) was similar to that of those with no pulmonary nodules and benign pulmonary nodules (60.9%, P = .6310; 44.0%, P = .899). Although diagnostic sensitivity for SPN before hepatectomy is low, timing of diagnosis does not affect OS. Conclusive lung resection offers OS similar to that of patients without lung metastases.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
The clinical significance of lung metastases regarded as subcentimeter pulmonary nodules (SPN) before hepatectomy for colorectal liver metastases (CLM) has not been assessed well.
METHODS
METHODS
The data from 569 patients undergoing hepatectomy for CLM from 2010 to 2016 were reviewed. The presence and final diagnosis of SPN were analyzed for their association with overall survival (OS).
RESULTS
RESULTS
A total of 143 patients had SPN (25.1%). SPN were proved to be lung metastases in 43 patients (30.1%). Before hepatectomy, lung metastases were suspected in 25 patients (sensitivity: 58%; specificity: 100%). The 5-year OS of patients with lung metastases (45.4%) was worse than that of those with no pulmonary nodules (60.9%, P = .003). There was no significant difference in the 5-year OS between the patients with lung metastases diagnosed after hepatectomy (48.7%) and before hepatectomy (41.2%, P = .432). The 5-year OS of patients who underwent surgery for lung metastases after hepatectomy (60.5%) was similar to that of those with no pulmonary nodules and benign pulmonary nodules (60.9%, P = .6310; 44.0%, P = .899).
CONCLUSION
CONCLUSIONS
Although diagnostic sensitivity for SPN before hepatectomy is low, timing of diagnosis does not affect OS. Conclusive lung resection offers OS similar to that of patients without lung metastases.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
523-528Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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