Pulmonary Metastasectomy for Colorectal Cancer: Evidence and Outcomes-A Narrative Review

Pulmonary metastasectomy for colorectal cancer represents a key component in modern oncological surgery, balancing precision resection with systemic disease management. Despite ongoing debate initiated by randomized trials, the surgical removal of lung metastases continues to offer significant survival benefits in well-selected patients. This review synthesizes the evolving landscape of pulmonary metastasectomy, integrating classical prognostic indicators, such as the disease-free interval (DFI) and carcinoembryonic antigen (CEA) levels, with emerging molecular insights including KRAS and BRAF mutations. The relationship between surgical radicality, systemic therapies, and personalized genetic profiling is redefining patient selection and optimizing outcomes. By dissecting recent evidence and ongoing controversies, we clarify the complex decision-making required to navigate this complex clinical terrain. Ultimately, the synergy of multidisciplinary care and precision surgery holds the promise of durable disease control and extended survival in colorectal cancer patients with lung metastases.