Colorectal cancer is the third-most-diagnosed cancer in males and in females, representing 8% of estimated new cases, and the third cause of cancer-related death in both sexes, accounting for 9% of cancer deaths in men and 8% in women. About 20% of patients diagnosed with CRC present metastatic disease. Although lung metachronous or synchronous metastatic spread without other involved sites has been reported in only a small proportion of patients, considering that this tumor is frequently diagnosed, the clinical approach to CRC pulmonary metastases represents a major issue for thoracic surgeons and CRC oncologists. Among patients diagnosed with pulmonary metastases from CRC, about 9–12% are eligible for local treatments with radical intent, including surgical resection, SBRT (stereotactic body radiation therapy) and ablation therapy. Due to the lack of randomized controlled trials among different local strategies, there is no definitive evidence about the optimal approach, although surgical resection is considered the most effective therapeutic option in this clinical scenario. Oncological achievement of primary radical resection, the biology of primary tumor and metastatic sites, disease free interval and or progression free survival are independent prognostic factors which make it possible to define a cohort of patients which might significantly benefit from pulmonary metastasectomy.
结直肠癌是男性和女性中第三大常见诊断癌症，约占新发病例的8%，同时也是两性癌症相关死亡的第三大原因，分别占男性癌症死亡总数的9%和女性癌症死亡总数的8%。约20%的确诊结直肠癌患者伴有转移性疾病。尽管仅有少数患者出现单纯肺部的异时性或同时性转移而无其他部位受累，但考虑到该肿瘤的高发病率，结直肠癌肺转移的临床处理策略已成为胸外科医师和结直肠肿瘤学家面临的重要课题。在确诊结直肠癌肺转移的患者中，约9%-12%适合接受根治性局部治疗，包括手术切除、立体定向放射治疗和消融治疗。由于缺乏不同局部治疗策略间的随机对照试验，目前尚无确凿证据表明何种方案最优，但在此临床情境中手术切除被视为最有效的治疗选择。原发灶根治性切除的肿瘤学结果、原发肿瘤与转移灶的生物学特性、无病生存期及无进展生存期等独立预后因素，有助于界定可能从肺转移瘤切除术中显著获益的患者群体。
Colorectal Cancer Pulmonary Metastasectomy: When, Why and How
肿瘤(癌症)患者之家