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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Prognostic Factors for Pulmonary Metastasectomy for Colorectal Cancer: A Propensity Score Matching Analysis.
Shoji Okado1, Shota Nakamura2, Minoru Sugihara3
1Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Anticancer Research
|January 30, 2026
Summary
Pulmonary metastasectomy for colorectal cancer (CRC) prognosis is significantly impacted by multiple metastases. Identifying prognostic factors like primary tumor site and nodule diameter is crucial for patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Pulmonary Medicine
Background:
- Colorectal cancer (CRC) frequently metastasizes to the lungs.
- Pulmonary metastasectomy is a potential curative option for select CRC patients.
- Understanding prognostic factors is vital for optimizing treatment strategies.
Purpose of the Study:
- To identify prognostic factors influencing survival after pulmonary metastasectomy in colorectal cancer patients.
- To evaluate the impact of primary tumor location on outcomes.
- To assess the prognostic significance of multiple pulmonary metastases.
Main Methods:
- Retrospective analysis of 289 patients undergoing pulmonary resection for CRC metastases.
- Multivariate Cox proportional hazards modeling to identify prognostic factors.
- Propensity score matching (PSM) to compare outcomes based on metastasis number.
Main Results:
- Primary tumor site, maximum pulmonary nodule diameter, and multiple metastases significantly impacted overall survival (OS).
- Smoking history and multiple metastases were significant predictors of disease-free survival (DFS).
- Patients with multiple metastases had significantly lower 5-year survival rates (48.0%) compared to single metastases (73.4%) after PSM.
Conclusions:
- Multiple pulmonary metastases are a significant negative prognostic factor for both OS and DFS after pulmonary metastasectomy in CRC.
- Prognostic factors identified can aid in patient selection and counseling for pulmonary metastasectomy.
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