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Objective: Thoracic Surgery Oncology Group 103 was a prospective multi-institutional trial that aimed to (1) evaluate the role of perioperative chemotherapy for low-risk patients with metastatic colorectal cancer undergoing pulmonary metastasectomy and (2) characterize the impact of surgery on outcomes for high-risk patients with metastatic colorectal cancer receiving chemotherapy. Methods: From July 2018 to September 2023, patients with histologically confirmed primary colorectal cancer and lung metastases amenable to complete margin-negative resection from 3 institutions were enrolled and stratified by low- and high-risk clinical features and randomized accordingly within 2 treatment paradigms. Results: = .95) months in the +SX group. Conclusions: Patient accrual targets were not reached, leaving this study underpowered; as such, all analyses are descriptive and hypothesis generating. We were unable to determine differences in survival in the high-risk cohort; however, our findings suggest that adequately selected low-risk individuals can be treated with up-front pulmonary metastasectomy without additional lung-directed chemotherapy.
Antonoff et al. (Fri,) studied this question.