Prognostic Factors for Pulmonary Metastasectomy for Colorectal Cancer: A Propensity Score Matching Analysis.

BACKGROUND/AIM: This study aimed to investigate prognostic factors in pulmonary metastasectomy for colorectal cancer (CRC), considering the location of the primary tumor.

PATIENTS AND

METHODS

We collected information from patients who underwent pulmonary resection for CRC at two high-volume centers from January 2010 to December 2023. Using a multivariate Cox proportional hazards model, patient background factors that affected the prognosis after pulmonary metastasectomy were identified.

RESULTS

A total of 289 patients were included in the study. The multivariate analysis revealed the primary tumor site [hazard ratio (HR)=1.89, p=0.016], the maximum diameter of the pulmonary nodule (HR=1.76, p=0.016), and multiple metastases (HR=2.10, p<0.001) had significant prognostic impact on overall survival (OS). The multivariate analysis of disease-free survival (DFS) revealed smoking history (HR=1.58, p=0.039) and multiple metastases (HR=2.08, p<0.001) as significant prognostic factors. After 1:1 propensity score matching (PSM) of patients based on the number of metastatic tumors, two populations revealed a consistent trend with 5-year survival rates of 73.4% and 48.0% for single pulmonary and multiple metastases.

CONCLUSION

Multiple metastases significantly worsened both OS and DFS after pulmonary metastasectomy, and the similar trend was observed after PSM.