Intended for healthcare professionals

Letters Operating to remove recurrent colorectal cancer

Questioning the benefit of lung metastasectomy in colorectal cancer

BMJ 2020; 368 doi: (Published 28 January 2020) Cite this as: BMJ 2020;368:m264
  1. Tom Treasure, clinical researcher
  1. Clinical Operational Research Unit, University College London, London WC1H 0BT, UK
  1. tom.treasure{at}

In The BMJ five years ago my colleagues and I questioned the appropriateness of a policy of early detection of colorectal metastases for surgical resection.1 We now have direct evidence from a randomised controlled trial (RCT) that any survival advantage from resection of colorectal lung metastases is, in all likelihood, very much smaller than has been assumed.2

There have been many uncontrolled reports of lung metastasectomy with five year survival of around 40%,3 a figure matched in the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) trial (38%, 95% confidence interval 23% to 62%).2 …

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