The surgical removal (resection) of colon cancer that has spread to the liver and lungs may result in long-term survival for select patients, according to recent results presented at the 36th Annual Meeting of The Society of Thoracic Surgeons.
The colon is a part of the body’s digestive system, forming a large portion of the large intestine. Treatment depends on the stage, or extent of spread of cancer, and may consist of chemotherapy, radiation, surgery and/or biological therapy (utilizing the body’s immune system to fight cancer). Two common sites to which colon cancer commonly spreads (metastasizes) are the liver and lungs. Optimal treatment regimens for metastatic sites to the liver and/or lungs are not established, with ongoing clinical trials underway to determine treatment options which yield superior long-term results.
Recently, physicians from the Mayo Clinic analyzed treatment and outcome data from 58 patients with colon cancer who had metastases to both the liver and lungs. None of these patients had a relapse of their cancer at the site of origin. All patients underwent the surgical removal of their metastases at the Mayo Institution between 1980 and 1988. There were no deaths during surgery. Five years following surgery, 55% of patients remained cancer-free. The two variables attributable to an increased risk of early death following treatment were an elevated carcinoembryonic antigen (a type of protein found on the surface of cancer cells) level and thoracic (chest) lymph node involvement prior to surgery. The number of cancer sites and the interval between primary surgery for colon cancer and surgery for metastases had no impact on survival.
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The physicians involved in analyzing this data concluded that select patients with colon cancer that has metastasized to the liver and lungs may achieve long-term survival with the surgical removal of these metastases. Patients responding optimally to this treatment option do not have thoracic lymph node involvement and do not have an elevated carcinoembryonic antigen level prior to surgery. Patients with colon cancer with liver and/or lung metastases may wish to speak with their physician about the risks and benefits of the surgical removal of their metastases or the participation in a clinical trial evaluating other promising therapeutic approaches. Sources of ongoing information regarding clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov). (Annals of Thoracic Surgery, Vol 71, pp 975-980, 2001).