Study Protocol for a Randomised Controlled Trial on Pulmonary Metastasectomy vs. Standard of Care in Colorectal Cancer Patients With ≥ 3 Lung Metastases (PUCC-Trial)

Schmid, Severin; Becker, Heiko; Fritsch, Ralph; Bausch, Johannes; Hunter, Natalie; Jenkner, Carolin; Hassan, Mohamed; Passlick, Bernward

doi:10.3389/fonc.2022.913896

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Currently, there is ongoing trail on the potential benefits of repeated operation for high-risk PM CRC with more than 3 lung metastasis. [21] Given the survival benefit, surgery should be the primary treatment option for recurrent lung metastasis.…”

Section: Redo Surgery For Crc With Pmmentioning

confidence: 99%

A review of surgery for lung metastasis from colorectal cancer

et al. 2023

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Lung is one of the most vulnerable organs for distant metastasis from colorectal cancer (CRC) with a mean survival time of 5 to 19 months in literature. For selected cases of lung metastasis from CRC, aggressive treatment can provide long-term survival benefit to the patients among which surgery can provide a significant better survival benefit than other treatment modalities. However, multimodality treatment approaches can provide further improvement for the clinical outcome. The advancement of minimally invasive surgery for the pulmonary diseases has offered the patients an effective treatment option for tumor eradication while a fast course of postoperative recovery. In the article, we reviewed the current status of treatment for pulmonary metastasis from CRC as well as the experience in the National Taiwan University Hospital.

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Section: Redo Surgery For Crc With Pmmentioning

confidence: 99%

A review of surgery for lung metastasis from colorectal cancer

et al. 2023

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“…A multicenter prospective RCT (PUCC-Trial) is now ongoing to investigate the effects of pulmonary metastasectomy in addition to standard medical treatment in comparison to standard medical treatment plus possible local ablative measures such as SBRT for patients with three or more resectable pulmonary metastases from CRC [ 100 ].…”

Section: Local Treatmentsmentioning

confidence: 99%

Optimizing Treatment Strategy for Oligometastases/Oligo-Recurrence of Colorectal Cancer

Yokoi,

Tajima,

Fukada

et al. 2023

Cancers

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Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the varied clinical scenarios giving rise to oligometastases necessitate a precise definition, considering primary tumor status and oncological factors, to optimize treatment strategies. This review delineates the concepts of oligometastatic CRC, encompassing oligo-recurrence, where the primary tumor is under control, resulting in a more favorable prognosis. A comprehensive examination of multidisciplinary treatment with local treatments and systemic therapy is provided. The overarching objective in managing oligometastatic CRC is the complete eradication of metastases, offering prospects of a cure. Essential to this management approach are local treatments, with surgical resection serving as the standard of care. Percutaneous ablation and stereotactic body radiotherapy present less invasive alternatives for lesions unsuitable for surgery, demonstrating efficacy in select cases. Perioperative systemic therapy, aiming to control micrometastatic disease and enhance local treatment effectiveness, has shown improvements in progression-free survival through clinical trials. However, the extension of overall survival remains variable. The review emphasizes the need for further prospective trials to establish a cohesive definition and an optimized treatment strategy for oligometastatic CRC.

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A Retrospective Analysis of Real-Life Management of Colorectal Cancer Lung-Limited Metastases Treated with Surgery: Outcomes and Prognostic Factors

Zurlo,

Calegari,

Congedo

et al. 2024

JCM

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Background: Unlike liver metastases, the role of surgery in colorectal cancer lung-limited metastases (CCLLM) is not yet established, and data are still poor. We performed a retrospective analysis to evaluate the impact of surgery on the management of CCLLM. Material and Method: We retrospectively analyzed patients who received surgery for CCLLM at our Institution from January 2010 to June 2019. The aim of the study was to evaluate the impact of clinical and pathological features on the survival (OS and DFS) of patients treated with surgery for CCLLM. Results: One hundred and fifty patients were included in the analysis. Seventy-six patients received preoperative chemotherapy (pCT) and 56 an adjuvant treatment (aCT), while 18 underwent up-front surgery without CT. In the whole population, median OS (mOS) and median DFS (mDFS) were 54.1 months (95%CI 44.0–82.1) and 24.0 months (95%CI 20.0–31.2), respectively. In multivariate analysis, number of metastases was the only factor correlated to DFS (p = 0.0006) and OS (p = 0.0018). Conclusion: Our study, although retrospective and of small size, shows that tumor burden (number of metastases) is the main prognostic factor in patients undergoing lung surgery for CCLLM. Moreover, our results suggest that surgery for lung metastases might prolong survival. These data strengthen the role of multidisciplinary management to allow patients with CCLLM to pursue local treatment whenever possible, even regardless of previous liver surgery or RAS mutated status.

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Study Protocol for a Randomised Controlled Trial on Pulmonary Metastasectomy vs. Standard of Care in Colorectal Cancer Patients With ≥ 3 Lung Metastases (PUCC-Trial)

Cited by 3 publications

References 23 publications

A review of surgery for lung metastasis from colorectal cancer

A review of surgery for lung metastasis from colorectal cancer

Optimizing Treatment Strategy for Oligometastases/Oligo-Recurrence of Colorectal Cancer

A Retrospective Analysis of Real-Life Management of Colorectal Cancer Lung-Limited Metastases Treated with Surgery: Outcomes and Prognostic Factors

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