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The purpose of this study was to investigate the prognostic factors for response to pulmonary metastasectomy and the efficacy of repeat pulmonary metastasectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective, single-institution study of 126 CRC patients who underwent pulmonary metastasectomy between 2000 and 2019 at the Gifu University Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 3- and 5-year survival rates were 84.9% and 60.8%, respectively. Among the 126 patients, 26 (20.6%) underwent a second pulmonary metastasectomy for pulmonary recurrence after initial pulmonary metastasectomy. Univariate analysis of survival identified seven significant factors: (1) gender (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04), (2) past history of extra-thoracic metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04), (3) maximum tumor size (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), (4) mediastinal lymph node metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), (5) preoperative carcinoembryonic antigen (CEA) level (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01), (6) preoperative carbohydrate antigen 19-9 (CA19-9) level (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), and (7) repeat pulmonary metastasectomy for pulmonary recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). On multivariate analysis, only mediastinal lymph node metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02, risk ratio 8.206, 95% confidence interval (CI) 1.566\u201334.962) and repeat pulmonary metastasectomy for pulmonary recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, risk ratio 0.054, 95% CI 0.010\u20130.202) were significant. Furthermore, in the evaluation of surgical outcomes, the safety of second pulmonary metastasectomy was almost the same as that of initial pulmonary metastasectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Repeat pulmonary metastasectomy is likely to be safe and effective for recurrent cases that meet the surgical criteria. However, mediastinal lymph node metastasis was a significant independent prognostic factor for worse overall survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12957-020-02076-3","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T12:05:20Z","timestamp":1606737920000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Prognostic factors in pulmonary metastasectomy and efficacy of repeat pulmonary metastasectomy from colorectal cancer"],"prefix":"10.1186","volume":"18","author":[{"given":"Masahiro","family":"Fukada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhisa","family":"Matsuhashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Okumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koyo","family":"Shirahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Iwata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Doi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"2076_CR1","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1016\/0003-4975(92)91435-C","volume":"53","author":"MK McAfee","year":"1992","unstructured":"McAfee MK, Allen MS, Trastek VF, Ilstrup DM, Deschamps C, Pairolero PC. 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As this study was a retrospective study and did not include any potentially identifiable patient data, informed consent was not obtained from the enrolled patients. The institutional review board gave the ethics approval for this retrospective study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"K. Yoshida has received honoraria for lectures from Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Eli Lilly and Company, Daiichi Sankyo Co., Ltd., Ono Pharmaceutical Co., Ltd., Merck Serono Co., Ltd., Novartis Pharma K.K., and Sanofi K.K.; and research funding from Ajinomoto Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ono Pharmaceutical Co., and Yakult Honsha Co., Ltd. outside the submitted work.T. Takahashi has received honoraria for lectures from Takeda Pharmaceutical Co., Ltd. All the remaining authors declare that they have no conflicts of interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"314"}}