Abstract 128P
Background
Lung metastasectomy (LM) with curative intent has become a widely accepted treatment for selected patients with stage IV colorectal cancer (CRC), but its oncological benefits have yet to be demonstrated by substantial evidence. The aim of this study was to assess the current practice of LM for CRC metastases in high-volume referral centres, focusing on short- and long-term outcomes.
Methods
An international multicentre study was designed with the support of the European Society of Thoracic Surgery (ESTS) Biology Club. This report details the preliminary results of the abovementioned study, based on data collected at Istituto Europeo di Oncologia (Milan, Italy) and Universitaire Ziekenhuizen Leuven (Leuven, Belgium).A retrospective analysis was performed on a subset of patients who underwent LM for CRC metastases from 2010 to 2018. Primary endpoints were overall survival (OS) and progression-free survival (PFS).Subgroup analyses and 1:1 propensity score matched (PSM) analyses were performed to minimise heterogeneity.
Results
This study included 297 patients, with a mean age of 62.8±14.7 years. There were no statistically significant differences in baseline preoperative characteristics between the two centres. Median OS and PFS were 96 and 59 months, respectively. The mean number of resected nodules was 3 (median 2, range 1-31). OS was significantly affected by postoperative adjuvant therapies for lung metastases (p=.023). At multivariate analysis, female sex and induction treatments for primary CRC were favourable prognostic factors (p=.047 and p=.003, respectively). PSM analyses (Wild Bootstrap Algorithm) showed that anatomical resections (ARs) and lymphadenectomy were associated with a longer OS (p=.001 and p=.009, respectively).
Conclusions
Our results confirm that LM is a safe and effective procedure for CRC metastases, with satisfactory oncological outcomes; in addition, this study suggests that ARs and lymphadenectomy are associated with improved survival.
Legal entity responsible for the study
European Institute of Oncology.
Funding
European Society of Thoracic Surgery.
Disclosure
All authors have declared no conflicts of interest.