Surgery of Lung Metastases in Colorectal Cancers

Introduction: Operating on the pulmonary metastases of colorectal cancers allows for prolonged survival and now integrates into multimodal treatments. The goal of this work is to show the benefit of this surgery, as well as the criteria of selecting patients who can benefit from it. Materials and Methods: Prospective monocentric study over two years. 50 pulmonary surgeries performed on 40 patients with 58 pulmonary metastases of colorectal cancer, in the department of Thoracic Surgery Mustapha Pacha University Hospital Algiers. Results: 17 men for 23 women were included. The average age was 65 years with extremes ranging from 28 to 74 years. The average free interval was 23 months. Tumor markers (CEA) were high in 13 cases. 8 of our patients had liver metastases. 5 Minimally invasive surgery, 27 metastasectomies, 4 segmentectomies, 7 lobectomies and 2 pneumonectomies were performed. Node removal was performed on 8 patients. All patients had an R0 resection. Post-operative mortality was nil; morbidity was 7,5%. Overall survival at 1 year was 97% and at 3 years, 88%. (95% IC: 82.15% -92.59%). Our work highlighted the following selection criteria: unique metastasis, a normal tumor marker rate, a long free interval, isolated and metachronous lung metastases, the certainty of being able to perform an R0 resection. Conclusion: Our study confirms that local control of pulmonary metastases increases the survival of these patients whose selection criteria must be rigorous in order for this surgery to be beneficial