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Lung surveillance following colorectal cancer pulmonary metastasectomy: Utilization of clinicopathologic risk factors to guide strategy.
Deboever, Nathaniel; Bayley, Erin M; Eisenberg, Michael A; Hofstetter, Wayne L; Mehran, Reza J; Rice, David C; Rajaram, Ravi; Roth, Jack A; Sepesi, Boris; Swisher, Stephen G; Vaporciyan, Ara A; Walsh, Garrett L; Bednarski, Brian K; Morris, Van K; Antonoff, Mara B.
Afiliación
  • Deboever N; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Bayley EM; Department of General Surgery, Baylor University, Houston, Tex.
  • Eisenberg MA; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Hofstetter WL; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Mehran RJ; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Rice DC; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Rajaram R; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Roth JA; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Sepesi B; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Swisher SG; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Vaporciyan AA; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Walsh GL; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Bednarski BK; Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Morris VK; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Tex.
  • Antonoff MB; Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex. Electronic address: MBAntonoff@MDAnderson.org.
J Thorac Cardiovasc Surg ; 167(3): 814-819.e2, 2024 Mar.
Article en En | MEDLINE | ID: mdl-37495170
BACKGROUND: Appropriately selected patients clearly benefit from resection of colorectal cancer (CRC) pulmonary metastases (PMs). However, there remains equipoise surrounding optimal chest surveillance strategies following pulmonary metastasectomy. We aimed to identify risk factors that may inform chest surveillance in this population. METHODS: Patients who underwent CRC pulmonary metastasectomy were identified from a single institution's prospectively maintained surgical database. Clinicopathologic and genomic characteristics were collected. Patients were stratified by diagnosis of subsequent PM within 6 months of the index lung resection. Multivariate modeling was used to evaluate risk factors. RESULTS: A total of 197 patients met the study's inclusion criteria, of whom 52.3% (n = 103) developed subsequent PM, at a median of 9.51 months following the index metastasectomy. Patients with KRAS alterations (odds ratio [OR], 3.073; 95% confidence interval [CI], 1.363-6.926; P = .007), TP53 alterations (OR, 3.109; 95% CI, 1.318-7.341; P = .010) were found to be at risk of PM diagnosis within 6 months of the index metastasectomy, while those with an APC alteration (OR, .218; 95% CI, 0.080-0.598; P = .003) were protected. Moreover, patients who received systemic therapy within 3 months of the initial PM diagnosis also were more likely to develop early lung recurrence (OR, 2.105; 95% CI, 0.971-4.563; P = .059). CONCLUSIONS: Patients with KRAS alterations, TP53 alterations, and no APC alterations developed early recurrence in the lung following pulmonary metastasectomy, as did those who received chemotherapy after their initial PM diagnosis. As such, these groups benefit from early lung imaging after metastasectomy, as chest surveillance protocols should be based on patient-centered clinicopathologic and genomic risk factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Metastasectomía / Neoplasias Pulmonares Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Metastasectomía / Neoplasias Pulmonares Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos