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Surgery Today
Erschienen in: Surgery Today 2/2021

28.08.2020 | Review Article

Past, present, and future perspectives of pulmonary metastasectomy for patients with advanced colorectal cancer

verfasst von: Tomohiro Murakawa

Erschienen in: Surgery Today | Ausgabe 2/2021

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Abstract

Over a half-century has passed since Thomford et al. proposed the selection criteria for pulmonary metastasectomy, and several prognostic factors have been identified. Although screening modalities and operations have changed dramatically, the important concepts of the selection criteria remain unchanged. Recent improvements in the survival outcomes of colorectal cancer patients undergoing pulmonary metastasectomy may be the result of strict adherence to the selection criteria for oligometastatic lung tumors, which can mimic local disease. Pulmonary metastasectomy has become an important option for selected patients with oligometastasis, based mainly on a large amount of retrospective data, but its effect on survival remains unclear. Curable pulmonary metastasis might be regarded as a “semi-local disease” under the spontaneous control of an acquired alteration in host immune status. The current practice of pulmonary metastasectomy for colorectal cancer focuses on selecting the most appropriate operation for selected patients. However, in the rapidly evolving era of immunotherapy, treatment-naïve patients for whom surgery is not suitable might be pre-conditioned by immunotherapy so that they may be considered for salvage surgery.
Literatur
1.
Shimizu H, Okada M, Tangoku A, Doki Y, Endo S, Fukuda H, et al. Thoracic and cardiovascular surgeries in Japan during 2017: annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2020;68:414–49.PubMed
2.
Ueda Y, Fujii Y, Kuwano H. Thoracic and cardiovascular surgery in Japan during 2007. Annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2009;57:488–513.PubMed
3.
Yasui H, Osada H, Ide H, Fujimura S. Thoracic and cardiovascular surgery in Japan during 1997. Annual report by the Japanese Association for Thoracic Surgery. Committee of Science. Jpn J Thorac Cardiovasc Surg. 1999;47:237–51.PubMed
4.
5.
Barney JD, Churchill EJ. Adenocarcinoma of the kidney with metastasis to the lung cured by nephrectomy and lobectomy. J Urol. 1939;42:269–76.
6.
Ehrenhaft JL, Lawrence MS, Sensenig DM. Pulmonary resections for metastatic lesions. AMA Arch Surg. 1958;77:606–12.PubMed
7.
Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg. 1965;49:357–63.PubMed
8.
9.
Van Cutsem E, Cervantes A, Adam R, Sobrero A, Van Krieken JH, Aderka D, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27:1386–422.PubMed
10.
11.
12.
13.
Handy JR, Bremner RM, Crocenzi TS, Detterbeck FC, Fernando HC, Fidias PM, et al. Expert consensus document on pulmonary metastasectomy. Ann Thorac Surg. 2019;107:631–49.PubMed
14.
McCormack PM, Bains MS, Beattie EJ Jr, Martini N. Pulmonary resection in metastatic carcinoma. Chest. 1978;73:163–6.PubMed
15.
Kondo H, Okumura T, Ohde Y, Nakagawa K. Surgical treatment for metastatic malignancies. Pulmonary metastasis: indications and outcomes. Int J Clin Oncol. 2005;10:81–5.PubMed
16.
Kobayashi K, Kawamura M, Ishihara T. Surgical treatment for both pulmonary and hepatic metastases from colorectal cancer. J Thorac Cardiovasc Surg. 1999;118:1090–6.PubMed
17.
Saito Y, Omiya H, Kohno K, Kobayashi T, Itoi K, Teramachi M, et al. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg. 2002;124:1007–133.PubMed
18.
Okumura T, Boku N, Hishida T, Ohde Y, Sakao Y, Yoshiya K, et al. Surgical outcome and prognostic stratification for pulmonary metastasis from colorectal cancer. Ann Thorac Surg. 2017;104:979–87.PubMed
19.
Gonzalez M, Poncet A, Combescure C, Robert J, Ris HB, Gervaz P. Risk Factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol. 2013;20:572–9.PubMed
20.
Pfannschmidt J, Dienemann H, Hoffmann H. Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg. 2007;84:324–38.PubMed
21.
Kadota K, Nitadori J, Sima CS, Ujiie H, Rizk NP, Jones DR, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas. J Thorac Oncol. 2015;10:806–14.PubMedPubMedCentral
22.
Shiono S, Ishii G, Nagai K, Yoshida J, Nishimura M, Murata Y, et al. Predictive factors for local recurrence of resected colorectal lung metastases. Ann Thorac Surg. 2005;80:1040–5.PubMed
23.
Nelson DB, Tayob N, Mitchell KG, Correa AM, Hofstetter WL, Sepesi B, et al. Surgical margins and risk of local recurrence after wedge resection of colorectal pulmonary metastases. J Thorac Cardiovasc Surg. 2019;157:1648–55.PubMed
24.
Sawabata N, Karube Y, Umezu H, Tamura M, Seki N, Ishihama H, et al. Cytologically malignant margin without continuous pulmonary tumor lesion: cases of wedge resection, segmentectomy and lobectomy. Interact Cardiovasc Thorac Surg. 2008;7:1044–8.PubMed
25.
Shiono S, Okumura T, Boku N, Hishida T, Ohde Y, Sakao Y, et al. Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer. Eur J Cardiothorac Surg. 2017;51:504–10.PubMed
26.
Hernández J, Molins L, Fibla JJ, Heras F, Embún R, Rivas JJ. Role of major resection in pulmonary metastasectomy for colorectal cancer in the Spanish prospective multicenter study (GECMP-CCR). Ann Oncol. 2016;27:850–5.PubMed
27.
Iida T, Nomori H, Shiba M, Nakajima J, Okumura S, Horio H, et al. Prognostic factors after pulmonary metastasectomy for colorectal cancer and rationale for determining surgical indications: a retrospective analysis. Ann Surg. 2013;257:1059–64.PubMed
28.
Viadana E, Bross ID, Pickren JW. The metastatic spread of cancers of the digestive system in man. Oncology. 1978;35:114–26.PubMed
29.
Viadana E, Bross ID, Pickren JW. The metastatic spread of kidney and prostate cancers in man. Neoplasma. 1976;23:323–32.PubMed
30.
Colombano SP, Reese PA. The cascade theory of metastatic spread: are there generalizing sites? Cancer. 1980;46:2312–4.PubMed
31.
Hwang MR, Park JW, Kim DY, Chang HJ, Kim SY, Choi HS, et al. Early intrapulmonary recurrence after pulmonary metastasectomy related to colorectal cancer. Ann Thorac Surg. 2010;90:398–404.PubMed
32.
Tanaka Y, Maniwa Y, Nishio W, Yoshimura M, Okita Y. The optimal timing to resect pulmonary metastasis. Eur J Cardiothorac Surg. 2008;33:1135–8.PubMed
33.
Krüger M, Schmitto JD, Wiegmann B, Rajab TK, Haverich A. Optimal timing of pulmonary metastasectomy—is a delayed operation beneficial or counterproductive? Eur J Surg Oncol. 2014;40:1049–55.PubMed
34.
Van Cutsem E, Cervantes A, Nordlinger B, Arnold D, ESMO Guidelines Working Group. Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(Suppl 3):iii1–9.PubMed
35.
Chen F, Miyahara R, Bando T, Okubo K, Watanabe K, Nakayama T, et al. Repeat resection of pulmonary metastasis is beneficial for patients with osteosarcoma of the extremities. Interact Cardiovasc Thorac Surg. 2009;9:649–53.PubMed
36.
Chen F, Fujinaga T, Sato K, Sonobe M, Shoji T, Sakai H, et al. Significance of tumor recurrence before pulmonary metastasis in pulmonary metastasectomy for soft tissue sarcoma. Eur J Surg Oncol. 2009;35:660–5.PubMed
37.
Burt BM, Ocejo S, Mery CM, Dasilva M, Bueno R, Sugarbaker DJ, et al. Repeated and aggressive pulmonary resections for leiomyosarcoma metastases extends survival. Ann Thorac Surg. 2011;92:1202–7.PubMed
38.
Treasure T, Fiorentino F, Scarci M, Møller H, Utley M. Pulmonary metastasectomy for sarcoma: a systematic review of reported outcomes in the context of Thames Cancer Registry data. BMJ Open. 2012;2:e001736.PubMedPubMedCentral
39.
Welter S, Jacobs J, Krbek T, Krebs B, Stamatis G. Long-term survival after repeated resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg. 2007;84:203–10.PubMed
40.
Kim AW, Faber LP, Warren WH, Saclarides TJ, Carhill AA, Basu S, et al. Repeat pulmonary resection for metachronous colorectal carcinoma is beneficial. Surgery. 2008;144:712–7.PubMed
41.
Park JS, Kim HK, Choi YS, Kim K, Shim YM, Jo J, et al. Outcomes after repeated resection for recurrent pulmonary metastases from colorectal cancer. Ann Oncol. 2010;21:1285–9.PubMed
42.
Chen F, Sakai H, Miyahara R, Bando T, Okubo K, Date H. Repeat resection of pulmonary metastasis is beneficial for patients with colorectal carcinoma. World J Surg. 2010;34:2373–8.PubMed
43.
Hishida T, Tsuboi M, Okumura T, Boku N, Ohde Y, Sakao Y, et al. Does repeated lung resection provide long-term survival for recurrent pulmonary metastases of colorectal cancer? Results of a Retrospective Japanese Multicenter Study. Ann Thorac Surg. 2017;103:399–405.PubMed
44.
Bellier J, De Wolf J, Hebbar M, Amrani ME, Desauw C, Leteurtre E, et al. Repeated resections of hepatic and pulmonary metastases from colorectal cancer provide long-term survival. World J Surg. 2018;42:1171–9.PubMed
45.
Menna C, Berardi G, Tierno SM, Andreetti C, Maurizi G, Ciccone AM, et al. Do repeated operations for recurrent colorectal lung metastases result in improved survival? Ann Thorac Surg. 2018;106:421–7.PubMed
46.
McCormack PM, Bains MS, Begg CB, Burt ME, Downey RJ, Panicek DM, et al. Role of video-assisted thoracic surgery in the treatment of pulmonary metastases: results of a prospective trial. Ann Thorac Surg. 1996;62:213–6.PubMed
47.
McCormack PM, Ginsberg KB, Bains MS, Burt ME, Martini N, Rusch VW, et al. Accuracy of lung imaging in metastases with implications for the role of thoracoscopy. Ann Thorac Surg. 1993;56:863–5.PubMed
48.
Nakajima J, Murakawa T, Fukami T, Sano A, Sugiura M, Takamoto S. Is finger palpation at operation indispensable for pulmonary metastasectomy in colorectal cancer? Ann Thorac Surg. 2007;84:1680–4.PubMed
49.
Eckardt J, Licht PB. Thoracoscopic or open surgery for pulmonary metastasectomy: an observer blinded study. Ann Thorac Surg. 2014;98:466–9.PubMed
50.
Eckardt J, Licht PB. Thoracoscopic versus open pulmonary metastasectomy: a prospective, sequentially controlled study. Chest. 2012;142:1598–602.PubMed
51.
Cerfolio RJ, Bryant AS, McCarty TP, Minnich DJ. A prospective study to determine the incidence of non-imaged malignant pulmonary nodules in patients who undergo metastasectomy by thoracotomy with lung palpation. Ann Thorac Surg. 2011;91:1696–700.PubMed
52.
Nakajima J, Murakawa T, Fukami T, Takamoto S. Is thoracoscopic surgery justified to treat pulmonary metastasis from colorectal cancer? Interact Cardiovasc Thorac Surg. 2008;7:212–6.PubMed
53.
Murakawa T, Sato H, Okumura S, Nakajima J, Horio H, Ozeki Y, et al. Thoracoscopic surgery versus open surgery for lung metastases of colorectal cancer: a multi-institutional retrospective analysis using propensity score adjustment. Eur J Cardiothorac Surg. 2017;51:1157–63.PubMed
54.
Parsons AM, Ennis EK, Yankaskas BC, Parker LA Jr, Hyslop WB, Detterbeck FC. Helical computed tomography inaccuracy in the detection of pulmonary metastases: can it be improved? Ann Thorac Surg. 2007;84:1830–6.PubMed
55.
Pfannschmidt J, Bischoff M, Muley T, Kunz J, Zamecnik P, Schnabel PA, et al. Diagnosis of pulmonary metastases with helical CT: the effect of imaging techniques. Thorac Cardiovasc Surg. 2008;56:471–5.PubMed
56.
Nakas A, Klimatsidas MN, Entwisle J, Martin-Ucar AE, Waller DA. Video-assisted versus open pulmonary metastasectomy: the surgeon's finger or the radiologist's eye? Eur J Cardiothorac Surg. 2009;36:469–74.PubMed
57.
Ellis MC, Hessman CJ, Weerasinghe R, Schipper PH, Vetto JT. Comparison of pulmonary nodule detection rates between preoperative CT imaging and intraoperative lung palpation. Am J Surg. 2011;201:619–22.PubMed
58.
Greenwood A, West D. Is a thoracotomy rather than thoracoscopic resection associated with improved survival after pulmonary metastasectomy? Interact Cardiovasc Thorac Surg. 2013;17:720–4.PubMedPubMedCentral
59.
Krüger M, Zinne N, Shin H, Zhang R, Biancosino C, Kropivnitskaja I, et al. Minimally invasive chest surgery. Is palpation control still necessary with modern computed tomography? Chirurgie. 2016;87:136–43.
60.
Macherey S, Doerr F, Heldwein M, Hekmat K. Is manual palpation of the lung necessary in patients undergoing pulmonary metastasectomy? Interact Cardiovasc Thorac Surg. 2016;22:351–9.PubMed
61.
Treasure T, Mineo T, Ambrogi V, Fiorentino F. Survival is higher after repeat lung metastasectomy than after a first metastasectomy: too good to be true? J Thorac Cardiovasc Surg. 2015;149:1249–52.PubMed
62.
Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113:37–49.PubMed
63.
Blackmon SH, Shah N, Roth JA, Correa AM, Vaporciyan AA, Rice DC, et al. Resection of pulmonary and extrapulmonary sarcomatous metastases is associated with long-term survival. Ann Thorac Surg. 2009;88:877–84.PubMed
64.
Maniwa T, Mori K, Ohde Y, Okumura T, Boku N, Hishida T, et al. Heterogeneity of tumor sizes in multiple pulmonary metastases of colorectal cancer as a prognostic factor. Ann Thorac Surg. 2017;103:254–60.PubMed
65.
Suissa S. Immortal time bias in pharmaco-epidemiology. Am J Epidemiol. 2008;167:492–9.PubMed
66.
Lévesque LE, Hanley JA, Kezouh A, Suissa S. Problem of immortal time bias in cohort studies: example using statins for preventing progression of diabetes. BMJ. 2010;340:b5087.PubMed
67.
Messmer BJ, Nora JJ, Leachman RD, Cooley DA. Survival-times after cardiac allografts. Lancet. 1969;293:954–6.
68.
Clark DA, Stinson EB, Griepp RB, Schroeder JS, Shumway NE, Harrison DC. Cardiac transplantation in man. VI. Prognosis of patients selected for cardiac transplantation. Ann Intern Med. 1971;75:15–211.PubMed
69.
Redelmeier DA, Singh SM. Survival in Academy Award-winning actors and actresses. Ann Intern Med. 2001;134:955–62.PubMed
70.
Internullo E, Cassivi SD, Van Raemdonck D, Friedel G, Treasure T. Pulmonary metastasectomy: a survey of current practice amongst members of the European Society of Thoracic Surgeons. J Thorac Oncol. 2008;3:1257–66.PubMed
71.
Embún R, Fiorentino F, Treasure T, Rivas JJ, Molins L. Pulmonary metastasectomy in colorectal cancer: a prospective study of demography and clinical characteristics of 543 patients in the Spanish colorectal metastasectomy registry (GECMP-CCR). BMJ Open. 2013;3:e002787.PubMedPubMedCentral
72.
Rodríguez-Fuster A, Belda-Sanchis J, Aguiló R, Embun R, Mojal S, Call S, et al. Morbidity and mortality in a large series of surgical patients with pulmonary metastases of colorectal carcinoma: a prospective multicentre Spanish study (GECMP-CCR-SEPAR). Eur J Cardiothorac Surg. 2014;45:671–6.PubMed
73.
Marron MC, Lora D, Gamez P, Rivas JJ, Embun R, Molins L, et al. Agreement between computed tomography and pathologic nodule counts in colorectal lung metastases. Ann Thorac Surg. 2016;101:259–65.PubMed
74.
Embun R, Rivas-de-Andrés JJ, Call S, de Olaiz-Navarro B, Freixinet JL, Bolufer S, et al. Causal model of survival after pulmonary metastasectomy of colorectal cancer: a nationwide prospective registry. Ann Thorac Surg. 2016;101:1883–900.PubMed
75.
Treasure T, Fallowfield L, Lees B. Pulmonary metastasectomy in colorectal cancer: the PulMiCC trial. J Thorac Oncol. 2010;5(6 Suppl 2):S203–S206206.PubMed
76.
Treasure T, Fallowfield L, Lees B, Farewell V. Pulmonary metastasectomy in colorectal cancer: the PulMiCC trial. Thorax. 2012;67:185–7.PubMed
77.
Treasure T, Farewell V, Macbeth F, Monson K, Williams NR, Brew-Graves C, et al. Pulmonary metastasectomy versus continued active monitoring in colorectal cancer (PulMiCC): a multicentre randomised clinical trial. Trials. 2019;20:718.PubMedPubMedCentral
78.
Smith B, Selby P, Southgate J, Pittman K, Bradley C, Blair GE. Detection of melanoma cells in peripheral blood by means of reverse transcriptase and polymerase chain reaction. Lancet. 1991;338:1227–9.PubMed
79.
Molnar B, Ladanyi A, Tanko L, Sréter L, Tulassay Z. Circulating tumor cell clusters in the peripheral blood of colorectal cancer patients. Clin Cancer Res. 2001;7:4080–5.PubMed
80.
Naito T, Tanaka F, Ono A, Yoneda K, Takahashi T, Murakami H, et al. Prognostic impact of circulating tumor cells in patients with small cell lung cancer. J Thorac Oncol. 2012;7:512–9.PubMed
81.
Paget S. The distribution of secondary growths in cancer of the breast. Lancet. 1889;133:571–3.
82.
Fidler IJ. The pathogenesis of cancer metastasis: the ‘seed and soil’ hypothesis revisited. Nat Rev Cancer. 2003;3:453–8.PubMed
83.
Chambers AF, Groom AC, MacDonald IC. Dissemination and growth of cancer cells in metastatic sites. Nat Rev Cancer. 2002;2:563–72.PubMed
84.
Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, Eder M, et al. Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol. 1986;150:195–203.PubMed
85.
Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13:8–10.
86.
Weichselbaum RR, Hellman S. Oligometastases revisited. Nat Rev Clin Oncol. 2011;8:378–82.PubMed
87.
88.
Payandeh Z, Khalili S, Somi MH, Mard-Soltani M, Baghbanzadeh A, Hajiasgharzadeh K, et al. PD-1/PD-L1-dependent immune response in colorectal cancer. J Cell Physiol. 2020;235:5461–75.PubMed
89.
Liu X, Guo CY, Tou FF, Wen XM, Kuang YK, Zhu Q, et al. Association of PD-L1 expression status with the efficacy of PD-1/PD-L1 inhibitors and overall survival in solid tumours: a systematic review and meta-analysis. Int J Cancer. 2020;147:116–27.PubMed
90.
Kuswanto WF, MacFarlane LA, Gedmintas L, Mulloy A, Choueiri TK, Bermas BL. Rheumatologic symptoms in oncologic patients on PD-1 inhibitors. Semin Arthritis Rheum. 2018;47:907–10.PubMed
91.
Osa A, Uenami T, Koyama S, Fujimoto K, Okuzaki D, Takimoto T, et al. Clinical implications of monitoring nivolumab immunokinetics in non-small cell lung cancer patients. JCI Insight. 2018;3:59125.PubMed
92.
Goldberg SB, Schalper KA, Gettinger SN, Mahajan A, Herbst RS, Chiang AC, et al. Pembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial. Lancet Oncol. 2020;21:655–63.PubMedPubMedCentral
93.
Grünhagen D, Jones RP, Treasure T, Vasilakis C, Poston GJ. The history of adoption of hepatic resection for metastatic colorectal cancer: 1984–95. Crit Rev Oncol Hematol. 2013;86:222–31.PubMed
94.
Treasure T. Metastasectomy for colorectal cancer: are there clothes on the emperor? J R Soc Med. 2017;110:227–30.PubMedPubMedCentral
95.
Corsini EM, Sepesi B. Commentary: salvage resection for stage IIIA lung cancer in the era of immunotherapy. Semin Thorac Cardiovasc Surg. 2020;32:160–1.PubMed
96.
Kidane B, Yasufuku K. Advances in image-guided thoracic surgery. Thorac Surg Clin. 2016;26:129–38.PubMed
97.
Keating J, Singhal S. Novel methods of intraoperative localization and margin assessment of pulmonary nodules. Semin Thorac Cardiovasc Surg. 2016;28:127–36.PubMed
98.
Lin MW, Chen JS. Image-guided techniques for localizing pulmonary nodules in thoracoscopic surgery. J Thorac Dis. 2016;8(Suppl 9):S749–S755755.PubMedPubMedCentral
99.
Kitano K, Sato M. Latest update about virtual-assisted lung mapping in thoracic surgery. Ann Transl Med. 2019;7:36.PubMedPubMedCentral
100.
Nakajima J. Advances in techniques for identifying small pulmonary nodules. Surg Today. 2019;49:311–5.PubMed
101.
Zhao ZR, Lau RWH, Yu PSY, Ng CSH. Devising the guidelines: the techniques of pulmonary nodule localization in uniportal video-assisted thoracic surgery-hybrid operating room in the future. J Thorac Dis. 2019;11(Suppl 16):S2073–S20782078.PubMedPubMedCentral
Metadaten
Titel
Past, present, and future perspectives of pulmonary metastasectomy for patients with advanced colorectal cancer
verfasst von
Tomohiro Murakawa
Publikationsdatum
28.08.2020
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 2/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02119-y

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