Affiliation:
1. National University Health System, Singapore
2. National University of Singapore, Singapore
Abstract
ABSTRACT
Introduction: Surgical resection of the primary and metastatic tumour is increasingly recommended
in suitable patients with metastatic colorectal cancer (CRC). While the role of metastasectomy is well
studied and established in colorectal liver metastasis, evidence remains limited in pulmonary metastases.
This systematic review was conducted to examine the current evidence on the role of lung metastasectomy
(LUM) in CRC.
Methods: Three databases were systematically searched, to identify studies that compared survival
outcomes of LUM, and factors that affected decision for LUM.
Results: From a total of 5,477 records, 6 studies were eventually identified. Two papers reported
findings from one randomised controlled trial and 4 were retrospective reviews. There was no clear survival
benefit in patients who underwent LUM compared to those who did not. When compared against patients
who underwent liver metastasectomy, there was also no clear survival benefit. Patients who underwent
LUM were also more likely to have a single pulmonary tumour, and metachronous disease.
Conclusion: The evidence suggests a role for LUM, but is limited by inherent selection bias in retrospective
reviews, and the single randomised clinical trial performed was not completed. More prospective studies
are required to understand the true effect of LUM on outcomes in metastatic CRC.
Keywords: Colorectal cancer, pulmonary metastasectomy, pulmonary metastases, survival
Publisher
Academy of Medicine, Singapore
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