Oncological benefit of complete metastasectomy for simultaneous colorectal liver and lung metastases

Treatment intention and outcome in patients with simultaneously diagnosed liver and lung metastases from colorectal cancer

“…This study confirms that patients with simultaneously diagnosed liver and lung metastases undergoing resection of all metastatic sites have a favourable prognosis with 5-year survival exceeding 50% [20]. Few studies exist on specifically simultaneously diagnosed liver and lung metastases and two of them report, similar to this study, a 5-year survival of 43e45% [8,9] while Matsumura et al found a 5-year survival of almost 72% [10]. On the contrary, a population-based study by Siebenhüer et al could not find a survival benefit for patients undergoing metastasectomy of combined liver and lung metastases [21].…”

“…The few studies on SLLM, where the initially intended hepatopulmonary resections were completed, report a 5-year survival of 43e72% [8e10] and demonstrate that patients with SLLM undergoing complete metastasectomy have similar survival to patients undergoing resection of isolated liver metastases [9,10]. Simultaneously detected liver and lung metastases, especially if diagnosed synchronously with the primary tumour, poses an even greater challenge since the sequence and timing of metastatic resections are influenced by potential symptoms from the primary tumour [11,12].…”

The Resection Rate of Synchronously Detected Liver and Lung Metastasis from Colorectal Cancer Is Low—A National Registry-Based Study

“…Even though no randomized trial has been performed on the topic, it is widely presumed that metastasectomy of both liver and lung metastases generates superior survival. Consistent with several other studies, a high estimated survival rate of 74% at 5 years was achieved among those selected to undergo complete metastasectomy in this study [7,9,23,26,27]. Contrary, the non-metastasectomy cohort, of which an unknown proportion had received palliative chemotherapy, had an estimated 5-year survival of 2.6%.…”

“…The low resection rate presented in this study of 2.3% is perceived as unexpectedly low. Most other studies on resection rates originates from surgical cohorts naturally affected by selection bias, also including both synchronously and metachronously detected liver and lung metastases and most often with an already resected primary tumor [7][8][9][10]. In these studies, about one-third of patients referred for the metastasectomy of simultaneously diagnosed liver and lung metastases underwent the intended curative treatment [7,10].…”