Local treatment combined with chemotherapy improves survival of patients with pulmonary metastases of colorectal cancer—a real-world retrospective study

Background The effect of local treatments for pulmonary metastases from colorectal cancer (CRC-PM) remains controversial. This study aims to figure out whether local treatments combined with chemotherapy could improve patients’ survival by comparing the outcomes of CRC-PM patients who submitted to local interventions combined with chemotherapy or just chemotherapy.Patients and Methods From January 2009 to July 2019, a total of 119 patients with CRC-PM from two surgical centers were reviewed. Patients were divided into two groups according to treatments for the lung metastases: Local intervention combined with chemotherapy (Group-LI) and Chemotherapy alone (Group-Chem). Overall survival (OS) and progression-free survival (PFS) were assessed with the Kaplan-Meier method. Clinical characteristics associated with prognosis were analyzed by using a Cox proportional hazards regression model. Propensity score matching analyses were used to overcome the possible biases in some baseline characteristics.Result Multivariable analysis revealed that the level of carcinoembryonic antigen (CEA) and treatment for CRC-PM are independent predictors of both OS and PFS. The median OS in Group-LI (n = 39) and Group-Chem (n = 80) were 34.5 months and 13.8 months, respectively(P < 0.001). The 3-year progression-free survival rate in Group-LI and Group-Chem were 75.2% and 45.1% (P < 0.001). After propensity score matching, patients in Group-LI had better OS (HR = 3.304, P = 0.022) and PFS (HR = 4.029, P < 0.001) than Group-Chem.Conclusion. CRC-PM patients with lower lever of CEA or local treatment of lung metastases are more likely to be those with favorable prognosis. Selected CRC-PM patients could benefit from local treatment of pulmonary metastases.