Background: The role of pulmonary metastasectomy has been increasingly questioned in the surgical community after the PulMiCC trial challenged its benefit in colorectal cancer. However, the view on pulmonary metastasectomy among people in non-surgical disciplines remains unclear. This study explored interdisciplinary attitudes toward pulmonary metastasectomy and identified the clinical expectations shaping its future role. Methods: An anonymous online survey of active board-certified physicians in oncology, urology, gynecology and dermatology was conducted (December 2024–June 2025). Twenty items covered attitudes to local ablative therapy, referral criteria, preferred modalities and future relevance. Group comparisons used Pearson’s χ2; ordinal ratings were compared by one-way ANOVA; associations were explored with Spearman’s ρ. Results: Of 2884 contacted physicians, 165 participated (≈5.7%), and 106 completed the questionnaire. All 106 (100%) endorsed local ablative therapy as meaningful; 92/106 (86.8%) favored routine integration into multimodal care. Surgical metastasectomy was selected by 49/106 (46.2%), SBRT was selected by 27/106 (25.5%) and image-guided ablation was selected by 7/106 (6.6%); preference for surgery differed by specialty (χ2(4) = 15.31,p= 0.004), while institutional availability (in-house thoracic surgery or radiation oncology) showed no association with selecting surgery or SBRT. Key referral determinants were number of lesions (105/106; 99.1%), anatomical location (86/106; 81.1%;p< 0.02 across specialties), and lesion size (81/106; 76.4%;p< 0.05); other factors showed no consistent inter-specialty differences. The perceived usefulness of metastasectomy was high (mode 8/10) and showed a weak, non-significant correlation with referral experience (ρ = 0.172,p= 0.077). Looking ahead, 46/106 (43.4%) anticipated a declining role of local ablative therapy with novel systemic therapies; interest in biomarker analysis from metastatic tissue compared to primary tumor tissue was very high 97/106 (91.5%). Conclusions: Local ablative therapy, particularly pulmonary metastasectomy, continues to be viewed as an integral and trusted element of metastatic disease management across specialties. Despite limited prospective evidence, clinicians maintain strong confidence in its clinical value and foresee its evolution toward biologically and patient-tailored indications. However, the interpretation of these findings is limited by a low response rate and potential selection bias toward European, academically affiliated respondents. To our knowledge, this is the first study to systematically capture perceptions of pulmonary metastasectomy among non-surgical oncology-related specialists.
背景：PulMiCC试验对肺转移瘤切除术在结直肠癌中的获益提出质疑后，其在外科领域的价值日益受到争议。然而，非外科领域人员对肺转移瘤切除术的看法尚不明确。本研究旨在探讨不同学科对肺转移瘤切除术的态度，并识别影响其未来角色的临床预期。方法：于2024年12月至2025年6月期间，对肿瘤学、泌尿外科、妇科学及皮肤科学领域活跃的执业认证医师开展匿名在线调查。问卷共20个项目，涵盖对局部消融治疗的态度、转诊标准、优选治疗模式及未来相关性评估。组间比较采用皮尔逊卡方检验；有序评分通过单因素方差分析比较；相关性分析采用斯皮尔曼ρ检验。结果：在2884名受邀医师中，165人参与（约5.7%），106人完成问卷。所有106名医师（100%）认可局部消融治疗具有临床意义；92人（86.8%）支持将其常规纳入多模式治疗。选择手术切除者49人（46.2%），立体定向放疗27人（25.5%），影像引导消融7人（6.6%）；手术偏好存在学科差异（χ2(4)=15.31，p=0.004），而机构内是否配备胸外科或放射肿瘤科资源与选择手术或立体定向放疗无显著关联。关键转诊决定因素包括病灶数量（105人，99.1%）、解剖位置（86人，81.1%；各学科间p<0.02）和病灶大小（81人，76.4%；p<0.05）；其他因素未呈现显著的学科间差异。肺转移瘤切除术的感知效用评分较高（众数8/10分），与转诊经验呈弱相关且未达显著水平（ρ=0.172，p=0.077）。展望未来，46人（43.4%）预期新型全身治疗将削弱局部消融治疗的地位；97人（91.5%）对转移灶与原发性肿瘤组织的生物标志物分析表现出高度兴趣。结论：局部消融治疗（尤其是肺转移瘤切除术）仍被各学科视为转移性疾病管理中不可或缺且值得信赖的组成部分。尽管前瞻性证据有限，临床医师对其临床价值保持强烈信心，并预见其将向基于生物学特征和患者个体化适应症的方向发展。但需注意，本研究受限于较低应答率及可能偏向欧洲学术机构受访者的选择偏倚。据我们所知，这是首项系统探究非外科肿瘤相关专科医师对肺转移瘤切除术认知的研究。
肿瘤(癌症)患者之家