Evaluating the effectiveness of anatomical versus non-anatomical resection in the surgery of lung metastases in patients with colorectal cancer.

This study evaluated the effectiveness of anatomical resection (AR) versus non-anatomical resection (NAR) in the surgery of lung metastases for patients with colorectal cancer (CRC). The data showed AR significantly improved cancer-specific survival outcomes compared to NAR in the surgery of lung metastases for patients with CRC.

CRC is one of the most common types of cancer worldwide. Some patients do not report symptoms with the initial tumor. These patients are often only diagnosed when the cancer has spread to other areas (metastatic CRC).

When CRC spreads, or metastasizes, one of the places it frequently goes to is the lung tissue. Surgical removal of the cancer, when possible, gives patients the best chances of survival. When the primary site of cancer in the large intestine has been removed, surgeons consider whether removing tumors that have spread from the original tumor location will be beneficial for the patients. This surgery is called a metastasectomy. Previous studies have shown that lung metastasectomy (surgery of lung metastases) improves survival for patients with CRC.

AR involves a procedure called a lobectomy in which the entire lobe (or a specific segment) of a lung is removed in which the cancer is present. NAR involves a procedure called a wedge resection in which only a wedge of the lung tissue is removed in which the cancer is present. However, it remains unclear whether AR or NAR provide better outcomes in the surgery of lung metastases in patients with CRC.

This study involved 295 patients who underwent surgery to remove lung metastases for CRC. 92 patients underwent AR. 203 patients underwent NAR. The average follow-up time was 34.6 months.

After 3-years, 64.1% of patients in the AR group were alive without any signs of cancer compared to 46.8% of the patients in the NAR group. Patients who received AR were 41.3% more likely to survive without any signs of cancer compared to those who received NAR.  

After 3-years, 75% of patients in the AR group were alive without any cancer in the lungs compared to 60.1% of the patients in the NAR group. Patients who received AR were 43.5% more likely to survive without any cancer in the lungs compared to those who received NAR.  

Overall, 92.4% of patients in the AR group were alive compared to 85.7% of the patients in the NAR group. This difference was not considered statistically significant. Patients who received AR were 48.9% more likely to have a better survival compared to those who received NAR. 

This study concluded that AR significantly improved cancer-specific survival outcomes compared to NAR in the surgery of lung metastases for patients with CRC.

This study looked back in time at medical records. The sample size was very small. This study only included patients treated at a single institution in China.