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A minority of patients with pulmonary metastases (PM) from colorectal cancer (CRC) are candidates for surgical therapy with a curative intent. The aim of this study was to identify parameters associated withprolonged survival after resection of PM from CRC.We performed a retrospective analysis of 40 patients who underwent resection of pulmonary metastases from CRC in a single institution.Follow-up was 33 (range 4-139) months. Median disease-free interval betweenprimary colorectal tumor and development of PM was 32.5 months. For the whole group, 3-and 5-year overall survival after thoracotomy was 70.1 and 43.4%, respectively. In multivariate analysis, two variables were correlated with tumor recurrence after thoracotomy; a history ofprevious liver metastases (HR = 3.8, 95% CI 1.4-9.8); and lung surgery other than wedge resection (HR = 3.0, 95% CI 1.1-7.8). Priorpresence of liver metastases was also correlated with an increased risk of death (HR = 5.1, 95% CI 1.1-24.8, P = 0.04). Median survival after thoracotomy was 87 (range 34-139) months in the group of patients without liver metastases versus 40 (range 28-51) months in patients who hadprior hepatic metastases (P = 0.09).The main parameter associated with poor survival after lung resection of CRC metastases is a history of resected liver metastases.