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Introduction. Although pulmonary metastasectomy is not part of the standard of care for colorectal cancer, it is widely used in practice. The question of its real effectiveness remains open for the time being. The effect of isolated lung chemoperfusion (ILCP) on the outcome of metastasectomy for colorectal cancer lung metastases has not been studied.
Aim. To identify a subgroup (cluster) of patients with colorectal cancer metastases to the lungs in whom metastasectomy followed by ILCP improves recurrence-free survival (RFS) in the lung compared with standard metastasectomy.
Materials and Methods. The material of the study was a sequential series of 152 observations of patients with colorectal lung metastases who underwent metastasectomy from 2016 to 2024 in the Thoracic Surgery Department of the N.N. Petrov NMRC of Oncology. The general selection criteria for pulmonary metastasectomy were cured primary tumour, cured secondary lesions, and absence of locoregional recurrence and functional resectability of the patients. The selection criteria for metastasectomy with ILCP were bilateral, multiple and recurrent pulmonary metastases. Almost all patients received therapeutic or adjuvant chemotherapy prior to metastasectomy. Open lung metastasectomy followed by ILCP was performed in 66 (43.4 %) patients; video-assisted and open standard metastasectomy were performed in 86 (56.6 %) patients.
Results. In patients selected for metastasectomy with ILCP the median recurrence-free pulmonary survival was 18.8 months. After standard metastasectomy the median RFS was 21.0 months. The use of ILCP did not fully compensate for the influence of adverse selection factors.
Conclusion. In colorectal cancer, metastasectomy followed by ILCP increases pulmonary RFS in a group of women younger than 71 years with bilateral and multiple pulmonary foci occurring earlier than 12 months after removal of the primary tumour. In our study, there were 20 of 66 such observations (30.3 ± 5.7 %). In the general cohort of patients with pulmonary metastases of colorectal cancer treated with modern drug therapy, ILCP with cisplatin as a method of one-time and short-term regional chemotherapy did not significantly affect pulmonary RFS.
Introduction. Although pulmonary metastasectomy is not part of the standard of care for colorectal cancer, it is widely used in practice. The question of its real effectiveness remains open for the time being. The effect of isolated lung chemoperfusion (ILCP) on the outcome of metastasectomy for colorectal cancer lung metastases has not been studied.
Aim. To identify a subgroup (cluster) of patients with colorectal cancer metastases to the lungs in whom metastasectomy followed by ILCP improves recurrence-free survival (RFS) in the lung compared with standard metastasectomy.
Materials and Methods. The material of the study was a sequential series of 152 observations of patients with colorectal lung metastases who underwent metastasectomy from 2016 to 2024 in the Thoracic Surgery Department of the N.N. Petrov NMRC of Oncology. The general selection criteria for pulmonary metastasectomy were cured primary tumour, cured secondary lesions, and absence of locoregional recurrence and functional resectability of the patients. The selection criteria for metastasectomy with ILCP were bilateral, multiple and recurrent pulmonary metastases. Almost all patients received therapeutic or adjuvant chemotherapy prior to metastasectomy. Open lung metastasectomy followed by ILCP was performed in 66 (43.4 %) patients; video-assisted and open standard metastasectomy were performed in 86 (56.6 %) patients.
Results. In patients selected for metastasectomy with ILCP the median recurrence-free pulmonary survival was 18.8 months. After standard metastasectomy the median RFS was 21.0 months. The use of ILCP did not fully compensate for the influence of adverse selection factors.
Conclusion. In colorectal cancer, metastasectomy followed by ILCP increases pulmonary RFS in a group of women younger than 71 years with bilateral and multiple pulmonary foci occurring earlier than 12 months after removal of the primary tumour. In our study, there were 20 of 66 such observations (30.3 ± 5.7 %). In the general cohort of patients with pulmonary metastases of colorectal cancer treated with modern drug therapy, ILCP with cisplatin as a method of one-time and short-term regional chemotherapy did not significantly affect pulmonary RFS.
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