Survival after lung metastasectomy for colorectal cancer: importance of previous liver metastasis as a prognostic factor.

AIMS: To analyse patient survival after the resection of lung metastases from colorectal carcinoma and specifically to verify whether presence of liver metastasis prior to lung metastasectomy affects survival. METHODS: All patients who, between 1998 and 2008, underwent lung metastasectomy due to colorectal cancer were included in the study. Kaplan-Meier survival analysis was performed with the log-rank test and Cox regression multivariate analysis. RESULTS: During this period, 101 metastasectomies were performed on 84 patients. The median age of patients was 65.4 years, and 60% of patients were male. The 30-day mortality rate was 2%, and incidence of complications was 7%. The overall survival was 72 months, with 3-and 5-year survival rates of 70% and 54%, respectively. A total of 17 patients (20%) had previously undergone resection of liver metastasis. No significant differences were found in the distribution of what were supposed to be the main variables between patients with and without previous hepatic metastases. Multivariate analysis identified the following statistically significant factors affecting survival: previous liver metastasectomy (p = 0.03), tumour-infiltrated pulmonary lymph nodes (p = 0.04), disease-free interval ≥ 48 months (p = 0.03), and presence of more than one lung metastasis (p < 0.01). In patients with previous liver metastasis, the shorter the time between primary colorectal surgery and the hepatectomy, the lower the survival rate after pulmonary metastasectomy (p = 0.048). CONCLUSIONS: A previous history of liver metastasis shortens survival after lung metastasectomy. The time between hepatic resection and lung metastasectomy does not affect survival; however, patients with synchronous liver metastasis and colorectal neoplasia have poorer survival rates than those with metachronous disease.

Enfermedad de Castleman y embarazo. ¿Casualidad o causalidad? / Castleman’s disease and pregnancy. Cause or coincidence?

La enfermedad de Castleman (EC) es un trastorno linfoproliferativo poco frecuente y clínicamente se diferencian la forma clínica localizada y la forma clínica multicéntrica. A pesar de su baja incidencia se han publicado otros casos de enfermedad de Castleman en mujeres embarazadas, sugiriendo una relación entre el embarazo y la enfermedad de Castleman. En este trabajo presentamos un caso de enfermedad de Castleman en una mujer embarazada tratada en nuestro hospital y revisamos la bibliografía relacionada con esta infrecuente entidad (AU)

Castleman’s disease is an infrequent lymphoproliferative disorder. Clinically, the localized form is distinguished from the multicentric form. Despite the low incidence of this entity, other cases of Castleman’s disease in pregnant woman have been published, suggesting that there may be a relationship between pregnancy and this disorder. We present a case of Castleman’s disease in a pregnant woman treated in our hospital and review the literature on this uncommon entity (AU)