Lung Metastasectomy: Where Do We Stand? Results from an Italian Multicentric Prospective Database

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Surgical resection of pulmonary metastases is a therapeutic option for select patients.
• A national multicenter prospective registry was established to evaluate lung metastasectomy outcomes.
• This study analyzes morbidity and overall survival (OS) from this registry.

Purpose of the Study:

• To assess the safety and efficacy of lung metastasectomy.
• To identify risk factors influencing morbidity and overall survival after lung metastasectomy.
• To evaluate the impact of surgical approach and patient characteristics on outcomes.

Main Methods:

• Retrospective analysis of prospectively collected data from a national Italian database.
• Inclusion of patients who underwent lung metastasectomy.
• Primary endpoints: morbidity and overall survival (OS); Secondary endpoints: risk factor analysis.

Main Results:

• 470 procedures on 461 patients (mean age 63.1 years); colorectal cancer metastases were most common (45.8%).
• Morbidity included prolonged air leaking and bleeding; no deaths or re-interventions reported.
• Overall survival significantly affected by disease-free interval > 24 months, epithelial histology, and colorectal histology (univariate analysis).

Conclusions:

• Lung metastasectomy is a safe procedure with acceptable morbidity, including minimally invasive approaches.
• Careful patient selection is crucial as it treats a local manifestation of systemic disease.
• Epithelial histology and disease-free interval > 24 months are significant factors for overall survival.