Gkikas, Andreas;
Kakos, Christos;
Lampridis, Savvas;
Godolphin, Peter J;
Patrini, Davide;
(2023)
Pre-operative prognostic factors for 5-year survival following pulmonary metastasectomy from colorectal cancer. A systematic review and meta-analysis.
European Journal of Cardio-Thoracic Surgery
, 63
(3)
, Article ezad059. 10.1093/ejcts/ezad059.
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Abstract
OBJECTIVES: We seek to identify pre-operative prognostic factors and measure their effect on 5-year survival following Pulmonary Metastasectomy (PM) for Colorectal Cancer (CRC). METHODS: We systematically reviewed the databases of Cochrane Library, MEDLINE, Embase and Google Scholar from January 2000-April 2021 to identify pre-operative factors that have been investigated for their prognostic effect on survival following PM. Quality assessment was performed using the QUIPS tool. The prognostic effect of each identified factor on 5-year survival post PM was estimated using random-effects meta-analyses. RESULTS: We identified 115 eligible articles which included 13,294 patients who underwent PM from CRC. The overall 5-year survival after resection of the lung metastasis was 54.1%. The risk of bias of the included studies was at least moderate in 93% (107/115). Seventy-seven pre-operative factors had been investigated for their prognostic effect. Our analysis showed that 11 factors had favorable and statistically significant prognostic effect on 5-year survival post-PM. These included solitary metastasis, size <2cm, unilateral location, N0 thoracic disease, no history of extra-thoracic or liver metastasis, normal carcinoembryonic antigen levels both before PM and CRC excision, no neo-adjuvant chemotherapy before PM, CRC T-stage < T4 and no p53 mutations on CRC. Disease free interval at 24 months did not appear to affect 5-year survival. CONCLUSION: Despite the considerable risk of bias in the literature, our study consolidates the available evidence on pre-operative prognostic factors for PM from CRC. These findings can complement both clinical practice and the design of future research on the field of PM.
| Type: | Article |
|---|---|
| Title: | Pre-operative prognostic factors for 5-year survival following pulmonary metastasectomy from colorectal cancer. A systematic review and meta-analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/ejcts/ezad059 |
| Publisher version: | https://doi.org/10.1093/ejcts/ezad059 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Pulmonary metastasectomy, Colorectal cancer, Prognostic factors, 5-year Survival, Meta-analysis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10165628 |
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