Multicentre retrospective analysis on pulmonary metastasectomy: an European perspective

Area of Science:

• Oncology
• Thoracic Surgery
• Cancer Research

Background:

• Pulmonary metastases represent a significant challenge in cancer management.
• Surgical resection of lung metastases (pulmonary metastasectomy) is an option for selected patients.
• Standardization of practice and outcomes across European centers is not well-defined.

Purpose of the Study:

• To evaluate the current practices and outcomes of pulmonary metastasectomy across 15 European centers.
• To analyze short- and long-term results of this surgical procedure.
• To identify factors influencing patient survival and recurrence-free survival.

Main Methods:

• Retrospective analysis of 1647 patients aged 18 years or older who underwent curative-intent pulmonary metastasectomy from January 2010 to December 2018.
• Data collected via a purpose-built REDCap database, excluding specific patient groups (e.g., prior metastasectomy, pneumonectomy).
• Analysis included patient demographics, primary tumor type, surgical approach (video-assisted thoracic surgery favored), resection details, and oncological outcomes.

Main Results:

• Colorectal adenocarcinoma was the most common primary tumor. Video-assisted thoracic surgery (VATS) was used in 54.9% of cases, with wedge resections being most frequent (67.1%).
• R0 resection (complete removal of all metastases) was achieved in 95.7% of cases. Thirty-day postoperative morbidity was 14.5%, with a mortality rate of 0.4%.
• Five-year overall survival was 62.0%, and recurrence-free survival was 29.6%.

Conclusions:

• Pulmonary metastasectomy is a low-risk surgical intervention.
• The procedure yields satisfactory oncological outcomes and patient survival rates.
• Further research is warranted to clarify controversial aspects in the daily clinical application of pulmonary metastasectomy.