title: History and present status of pulmonary metastasectomy in colorectal cancer.
abstract: Clinical practice with respect to metastatic colorectal cancer differs from the other two most common cancers, breast and lung, in that routine surveillance is recommended with the specific intent of detecting liver and lung metastases and undertaking liver and lung resections for their removal. We trace the history of this approach to colorectal cancer by reviewing evidence for effectiveness from the 1950s to the present day. Our sources included published citation network analyses, the documented proposal for randomised trials, large systematic reviews, and meta-analysis of observational studies. The present consensus position has been adopted on the basis of a large number of observational studies but the randomised trials proposed in the 1980s and 1990s were either not done, or having been done, were not reported. Clinical opinion is the mainstay of current practice but in the absence of randomised trials there remains a possibility of selection bias. Randomised controlled trials (RCTs) are now routine before adoption of a new practice but RCTs are harder to run in evaluation of already established practice. One such trial is recruiting and shows that controlled trial are possible.
authors.affiliation: Tom Treasure, Clinical Operational Research Unit, University College London, London WC1E 6BT, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Treasure
authors.affiliation: Tom Treasure, Clinical Operational Research Unit, University College London, London WC1E 6BT, United Kingdom.
authors.forename: Mišel
authors.initials: M
authors.lastname: Milošević
authors.affiliation: Tom Treasure, Clinical Operational Research Unit, University College London, London WC1E 6BT, United Kingdom.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fiorentino
authors.affiliation: Tom Treasure, Clinical Operational Research Unit, University College London, London WC1E 6BT, United Kingdom.
authors.forename: Joachim
authors.initials: J
authors.lastname: Pfannschmidt
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D019317:Evidence-Based Medicine; D006498:Hepatectomy; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D059146:Metastasectomy / Q000009:adverse effects / Q000266:history / Q000401:mortality / Q000639:trends; D011013:Pneumonectomy / Q000009:adverse effects / Q000266:history / Q000401:mortality / Q000639:trends; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002272:Carcinoembryonic Antigen
keywords: Colorectal cancer; Liver resection; Metastasectomy; Oligometastatic state; Pulmonary metastasectomy