Background. This study aims to clarify which patients would benefit by surg
ery for pulmonary metastases from colorectal carcinoma.
Methods. A retrospective study was undertaken in 25 patients who had underg
one complete resection. In all cases, prethoracotomy carcinoembryonic antig
en (CEA) level was measured and mediastinal or hilar lymph nodes were histo
Results. Overall 5-year survival was 39.2%. The 5-year survival rate for pa
tients with a normal CEA level was 61.1%, as compared with 19.0% for patien
ts with an elevated CEA level (p = 0.0423). The 5-year survival rate for pa
tients without a lymph node metastasis was 49.5%, as compared with 14.3% fo
r patients with a lymph node metastasis (p = 0.0032). No lymph node metasta
sis was a predictor of longer survival by univariate and multivariate analy
ses. The primary site, disease-free interval, and number and size of the me
tastasis were not significant prognostic factors.
Conclusions. A resection for pulmonary metastasis from colorectal carcinoma
is effective in patients with a normal CEA level and without a lymph node
metastasis. (C) 2000 by The Society of Thoracic Surgeons.