Background: Pulmonary metastasectomy has evolved as a potential treatment that can offer long-term survival in fit patients with controlled primary cancers and limited lung metastases. However, most evidence is derived from large retrospective studies and there is a lack of data from randomised trials. We aim to analyse the short and medium-term outcomes and clinical experience of pulmonary metastasectomy. Patients and methods: Retrospective analysis of patients who underwent metastasectomy between January 1, 2020 and March 1, 2023. Results: A total of 202 patients were included. Most patients were males (58%) with a median age of 66 years. About 61% of patients were referred with colorectal cancer, followed by renal cell cancer (11%). Most patients underwent video-assisted surgery (n = 107, 53%). Most patients underwent a single or multiple sub-lobar nonanatomical wedge resection (n = 135, 67%). The median length of hospital stay was 3 days. Complications occurred in four patients, with one reported in-patient death. Among the patients with confirmed pathological metastases (n = 193), the median observation period was 51 months (31–66). During this period, 27 patients required redo surgeries, with a median interval of 8 months. Except for one patient, who underwent two redo surgeries, all patients had one redo surgery. Mortality was 37% of during the observation period. Conclusion: Surgery is safe and feasible with good short and medium-term outcomes in selected patients. The survival benefit requires randomised trials respective to each tumour type, or commonly presented ones, to establish solid evidence if surgery lengthens survival.
Allam et al. (Sun,) studied this question.