Objective

There is limited information on the safety, effectiveness and long-term survival of patients following pulmonary metastasectomy for colorectal malignancies in Wales.

Methods

All patients who underwent pulmonary resection for colorectal malignancies at our institution between 2009 and October 2015 were reviewed. Postoperative morbidity, mortality and long-term survival were analyzed in consecutive 41 patients (24 male [58.5%], median age 63 years[IQR] 56-71 years) with metastatic disease limited to the lung and/or liver.

Results

The primary sites were 5 (12%) colonic, 15 (36.5%) sigmoidal and 21 (51.5%) rectal, and all were adenocarcinoma. The median disease free interval was 2 (range 0-6) years. 8 (19.5%) had bilateral & 33 (80.5%) unilateral disease, whilst 7 (17%) had liver metastasis. 35 (85%) underwent unilateral pulmonary metastasectomy. All 41 patients had R0 resection. Both the 30 & 90 day mortality were zero (0%). The 1 year actual survival was 97% and 5 year actuarial survival 89% (95% CI 81-94%).

Conclusion

Pulmonary resection for metastatic colorectal disease in selected patients is safe and effective with good long term survival.