Surgery and ablative techniques for lung metastases in the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) trial: is there equivalence?

Treasure, Tom

doi:10.21037/jtd.2016.06.50

Cited by 14 publications

(12 citation statements)

References 20 publications

(18 reference statements)

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“…Image-guided ablative therapies including radiofrequency ablation (RFA), cryoablation, microwave ablation (MWA), and laser-induced thermal therapy (LITT) have also emerged as potential minimally invasive alternatives to surgical resection. 84) RFA and cryoablation are more commonly offered and have been shown to have similar 5-year survival rates to surgical resection. 84–86) De Baere et al, in a large retrospective analysis of 562 patients, reported overall 5-year survival of 51.5% and median survival of 62 months following RFA for pulmonary metastases, however 67% of procedures were complicated by a pneumothorax, with 58% of those patients requiring intercostal catheter insertion.…”

Section: Discussionmentioning

confidence: 99%

“…84) RFA and cryoablation are more commonly offered and have been shown to have similar 5-year survival rates to surgical resection. 84–86) De Baere et al, in a large retrospective analysis of 562 patients, reported overall 5-year survival of 51.5% and median survival of 62 months following RFA for pulmonary metastases, however 67% of procedures were complicated by a pneumothorax, with 58% of those patients requiring intercostal catheter insertion. 87) RFA like pulmonary metastasectomy is founded predominantly upon retrospective data and therefore liable to the same bias.…”

Section: Discussionmentioning

confidence: 99%

“…85) Currently, no prospective randomized data have been published comparing surgery to RFA. 84,85) In 2014, Schlijper et al conducted a systematic review comparing pulmonary metastasectomy to RFA concluding that although current evidence largely supports surgery as the most effective option, no firm conclusions can made without more robust data. 85,86) The safety and efficacy of cryoablative therapy for pulmonary metastases is currently being examined in the ECLIPSE trial, a prospective single arm study.…”

Section: Discussionmentioning

confidence: 99%

“…87,88) While these ablative therapies do offer a minimally invasive option, they do not enable the same histopathological scrutiny as surgical resection, which can guide adjuvant systemic treatment. 84) Ablation destroys malignant tissues and tumor samples are not obtained. 84,91) Compounding the issue is when no tissue diagnosis is available prior to ablative therapy, and often a new or enlarging lung mass on CT with PET avidity is considered diagnostic of metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

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The Past, Present and Future of Pulmonary Metastasectomy: A Review Article

Cheung

Alam

Wright

2019

ATCS

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Pulmonary metastases are a sign of advanced malignancy and an omen of poor prognosis. Once primary tumors metastasize, they become notoriously difficult to treat and interdisciplinary management often involves a combination of chemotherapy, radiotherapy, and surgery. Over the last 25 years, the emerging body of evidence has recognized the curative potential of pulmonary metastasectomy. Surgical resection of pulmonary metastases is now commonly considered for patients with controlled primary disease, absence of widely disseminated extrapulmonary disease, completely resectable lung metastases, sufficient cardiopulmonary reserve, and lack of a better alternative systemic therapy. Since the development of these selection criteria, other prognostic factors have been proposed to better predict survival and optimize the selection of surgical candidates. Disease-free interval (DFI), completeness of resection, surgical approach, number and laterality of lung metastases, and lymph node metastases all play a dynamic role in determining patient outcomes. There is a definite need to continue reviewing these prognosticators to identify patients who will benefit most from pulmonary metastasectomy and those who should avoid unnecessary loss of lung parenchyma. This literature review aims to explore and synthesize the last 25 years of evidence on the long-term survival, prognostic factors, and patient selection process for pulmonary metastasectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Past, Present and Future of Pulmonary Metastasectomy: A Review Article

Cheung

Alam

Wright

2019

ATCS

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“…The lack of benefits of lymphadenectomy has already been reported by other groups . In addition, stereotactic body radiotherapy (SBRT) is gaining increasing popularity and some trials are ongoing comparing outcomes between surgery an SBRT . If the results will confirm a non‐inferiority of SBRT over surgery, the former might become an attractive option for this patients due to its lower invasiveness and reduced overall risks .…”

Section: Commentmentioning

confidence: 99%

Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Londero

Morelli

Parise

et al. 2019

Journal of Surgical Oncology

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Background and Objectives: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice. Methods: One hundred eighty‐one patients undergoing a first PM were studied. Eighty‐six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L−group). Main outcomes were overall survival (OS) and disease‐free survival (DFS). Median follow‐up was 25 months (interquartile range [IQR], 13‐49). Results: At follow‐up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5‐year survival (L+ 30.0% vs L− 43.2%; P = .87) or in the 5‐year cumulative incidence of recurrence (L + 63.2% vs L−80%; P = .07) between the two groups. Multivariable analysis indicated that disease‐free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non‐small–cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11‐fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence. Conclusion: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

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Techniques for Pulmonary Metastasectomy

Sayan

Yıldızeli

2020

Thoracic Surgery

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Surgery and ablative techniques for lung metastases in the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) trial: is there equivalence?

Cited by 14 publications

References 20 publications

The Past, Present and Future of Pulmonary Metastasectomy: A Review Article

The Past, Present and Future of Pulmonary Metastasectomy: A Review Article

Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Techniques for Pulmonary Metastasectomy

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