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Anatomical Versus Non-Anatomical Pulmonary Metastasectomy: European Multicentre Analysis.
Elena Prisciandaro1,2, Luca Bertolaccini3,4, Steffen Fieuws5
1Department of Thoracic Surgery, University Hospitals of Brussels, 1070 Brussels, Belgium.
Cancers
|March 28, 2026
Summary
Non-anatomical pulmonary metastasectomy offers comparable survival and lower morbidity versus anatomical resection. Limited lung resections are preferred when feasible, though anatomical resections remain valid for select cases.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Pulmonary metastasectomy lacks standardized procedures, with no consensus on optimal resection extent.
- This study compares outcomes of anatomical versus non-anatomical pulmonary metastasectomy.
Purpose of the Study:
- To compare short- and long-term outcomes of anatomical versus non-anatomical pulmonary metastasectomy.
- To evaluate overall survival, recurrence-free survival, and morbidity.
Main Methods:
- Retrospective analysis of 1647 patients undergoing curative intent pulmonary metastasectomy (2010-2018).
- Exclusion of pneumonectomy, prior metastasectomies, and extrapulmonary recurrence.
- 3:1 matching used to compare anatomical and non-anatomical resection groups.
Main Results:
- Matched cohort: 324 anatomical vs. 830 non-anatomical resections.
- No significant difference in overall survival between groups (5-year OS 62.0%).
- Non-anatomical resection showed lower 30-day morbidity (13.7% vs. 22.2%) and comparable recurrence-free survival. Anatomical resection yielded longer locoregional recurrence-free survival.
Conclusions:
- Non-anatomical resection demonstrated comparable survival and reduced morbidity in a selected cohort.
- Favorable limited resections are supported when technically and oncologically feasible.
- Anatomical resections are a valid option for selected cases with acceptable outcomes.
