Pulmonary metastasectomy in colorectal carcinoma

Beckers, Paul A. J.; Berzenji, Lawek; Yogeswaran, Suresh Krishan; Lauwers, Patrick; Bilotta, Giada; Shkarpa, Nikol; Hendriks, Jeroen; Schil, Paul E. Van

doi:10.21037/jtd-2019-pm-14

Cited by 13 publications

(10 citation statements)

References 80 publications

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“…Similar to metastatic sarcoma, scientific evidence derived by several studies confirm that colorectal carcinoma is a favorable histological subtype for metastasectomy (40)(41). Several case series in the following years confirmed this and reported excellent 5-year survival rates, with some studies reporting rates up to 68% at 5 years (42). Many prognostic factors for colorectal cancer after PM have been reported in literature over the past decades.…”

Section: Surgery According To the Histological Typementioning

confidence: 80%

“…Recently, experimental surgical techniques such as isolated lung perfusion with melphalan have shown promising results for unresectable metastatic colorectal cancer in animals, and phase I and II studies in patients affected by resectable pulmonary metastases from colorectal cancer, osteosarcoma, and soft-tissue sarcoma (69)(70). Finally, future developments in minimally invasive approaches such as RATS and systemic treatments are likely to change the landscape and treatment guidelines for patients with metastatic lung disease.…”

Section: Innovation and Future Perspective In Thoracic Surgerymentioning

confidence: 99%

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Pulmonary Metastases: Surgical Principles, Surgical Indications, and Innovations

Mangiameli,

Cioffi,

Alloisio

et al. 2022

Metastasis

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Pulmonary metastasectomy is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In this chapter, we discuss the state-of-the-art thoracic surgery in surgical management of lung metastases. The principles of pulmonary metastasectomy, followed by a comparison between thoracotomy and mini-invasive surgery are presented. Different surgical indications, and oncological outcomes according to the surgical approach (open vs mini-invasive), histological types and the number of metastatic nodules in the lung are discussed. Finally, the role of surgical margin, lymphadenectomy, and surgical resection of recurrent metastases along with a brief overview of the future perspectives in thoracic surgery in the treatment of lung metastases are presented.

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Section: Surgery According To the Histological Typementioning

confidence: 80%

Section: Innovation and Future Perspective In Thoracic Surgerymentioning

confidence: 99%

Pulmonary Metastases: Surgical Principles, Surgical Indications, and Innovations

Mangiameli,

Cioffi,

Alloisio

et al. 2022

Metastasis

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“…Lung metastases are not uncommon in patients with CRC, being detected in up to 15% of all CRC cases (31).…”

Section: Discussionmentioning

confidence: 99%

“…The 5-year survival rate of untreated metastatic CRC is remarkably poor (32), however, in a subset of patients with resectable disease, radical PM with curative intent can lead to long-term survival (31,33).…”

Section: Discussionmentioning

confidence: 99%

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Impact of the extent of lung resection on postoperative outcomes of pulmonary metastasectomy for colorectal cancer metastases: an exploratory systematic review

Prisciandaro¹,

Ceulemans²,

Raemdonck³

et al. 2022

J Thorac Dis

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Background: Pulmonary metastasectomy (PM) with curative intent has become a widely accepted treatment for lung metastases from solid tumours in selected patients, with low perioperative morbidity and mortality. In particular, PM is strongly recommended in selected patients with secondary lesions from colorectal cancer (CRC), due to its excellent postoperative prognosis. Nevertheless, the impact of the extent of PM on recurrence and survival remains controversial. This review aimed at assessing differences in shortand long-term postoperative outcomes depending on the extent of lung resection for lung metastases.Methods: A systematic literature review of studies comparing anatomical and non-anatomical resections of lung metastases was performed (Prospective Register of Systematic Reviews Registration: 254931).A literature search for articles published in English between the date of database inception and January 31, 2021 was performed in EMBASE (via Ovid), MEDLINE (via PubMed) and Cochrane CENTRAL.Retrospective studies, randomised and non-randomised controlled trials were included. The Cochrane Collaboration tool was used to determine the risk of bias for the primary outcome for included studies.Results: Out of 432 papers, three retrospective non-randomised studies (1,342 patients) were selected for systematic reviewing. Although our search design did not exclude any primary tumour histology, all selected studies investigated surgical resection of lung metastases from CRC. Because of variations in the compared surgical approaches to pulmonary metastases, a meta-analysis proved unfeasible. There was a tendency to perform anatomical resections for larger metastases. Multivariate analyses revealed that anatomical resections were protective for recurrence-free survival (RFS), while the impact of such procedures on overall survival (OS) remained uncertain. A significantly higher incidence of resection-margin recurrences was observed in patients who underwent non-anatomical resections.Discussion: Anatomical resections of lung metastases from CRC seem to be associated with improved RFS. However, well-constructed comparative clinical trials focusing on the extent of PM are needed.

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Do resected colorectal cancer patients need early chest imaging? Impact of clinicopathologic characteristics on time to development of pulmonary metastases

Deboever,

Bayley,

Eisenberg

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesFor patients with colorectal cancer (CRC), the lung is the most common extra‐abdominal site of distant metastasis. However, practices for chest imaging after colorectal resection vary widely. We aimed to identify characteristics that may indicate a need for early follow‐up imaging.MethodsWe retrospectively reviewed charts of patients who underwent CRC resection, collecting clinicopathologic details and oncologic outcomes. Patients were grouped by timing of pulmonary metastases (PM) development. Analyses were performed to investigate odds ratio (OR) of PM diagnosis within 3 months of CRC resection.ResultsOf 1600 patients with resected CRC, 233 (14.6%) developed PM, at a median of 15.4 months following CRC resection. Univariable analyses revealed age, receipt of systemic therapy, lymph node ratio (LNR), lymphovascular and perineural invasion, and KRAS mutation as risk factors for PM. Furthermore, multivariable regression showed neoadjuvant therapy (OR: 2.99, p < 0.001), adjuvant therapy (OR: 6.28, p < 0.001), LNR (OR: 28.91, p < 0.001), and KRAS alteration (OR: 5.19, p < 0.001) to predict PM within 3 months post‐resection.ConclusionsWe identified clinicopathologic characteristics that predict development of PM within 3 months after primary CRC resection. Early surveillance in such patients should be emphasized to ensure timely identification and treatment of PM.

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Pulmonary metastasectomy in colorectal carcinoma

Cited by 13 publications

References 80 publications

Pulmonary Metastases: Surgical Principles, Surgical Indications, and Innovations

Pulmonary Metastases: Surgical Principles, Surgical Indications, and Innovations

Impact of the extent of lung resection on postoperative outcomes of pulmonary metastasectomy for colorectal cancer metastases: an exploratory systematic review

Do resected colorectal cancer patients need early chest imaging? Impact of clinicopathologic characteristics on time to development of pulmonary metastases

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