Surgical Management of Pulmonary Metastases from Colorectal Adenocarcinoma: Outcomes and Clinicopathological Insights

Abstract

<bold>Background:</bold> Pulmonary metastases are a frequent complication of colorectal adenocarcinoma (CRC) and thoracic surgery offers a potential curative option. This study evaluates the clinicopathological characteristics and surgical outcomes of patients undergoing pulmonary metastasectomy for CRC-related lung metastases. <bold>Methods:</bold> A retrospective analysis was conducted on 23 patients(13 males, 10 females; mean age 58.7) with histologically confirmed CRC who underwent pulmonary metastasectomy between 2010 and 2018 at a single thoracic surgery center. Data included primary tumor location, surgical approach (video-assisted thoracoscopic surgery, thoracotomy, or mini-thoracotomy), histopathological findings, and prior treatments (surgery, chemotherapy, and/or radiotherapy). Outcomes assessed were perioperative complications, histopathological confirmation of metastases, and long-term follow-up. <bold>Results:</bold> The primary tumor was rectal in 16cases(69.6%) and colonic in 7 cases(30.4%). Pulmonary metastases were bilateral in 7 patients (30.4%) and unilateral in 16(69.6%), with a median of 2 nodules. Surgical approaches included VATS (30.4%), posterolateral thoracotomy (52.2%), and mini-thoracotomy (17.4%). Histopathology confirmed adenocarcinoma metastases in 18 cases (78.3%), with non-small cell carcinoma (NSCLC) identified in 3 cases(13%). Prior treatments included colorectal surgery(91.3%), adjuvant chemotherapy(73.9%), and radiotherapy (47%). <bold>Conclusion:</bold> Pulmonary metastasectomy for CRC-related lung metastases is a feasible and safe procedure, with VATS and thoracotomy being effective approaches. These findings underscore the role of thoracic surgery in the management of metastatic CRC.