Randomised Controlled Trial Evidence Questions the Assumption that Pulmonary Metastasectomy Benefits Patients with Colorectal Cancer


Pulmonary metastasectomy for sarcoma is surgery without proven benefit, and in the light of a randomized controlled trial examining pulmonary metastasectomy in colorectal cancer, it should be questioned.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Yamamoto H, Yamamoto H, Soh J. A Simple prognostic benefit scoring system for sarcoma patients with pulmonary metastases: sarcoma lung metastasis score. Ann Surg Oncol. 2020. https://doi.org/10.1245/s10434-020-09272-1.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Milosevic M, Edwards J, Tsang D, Dunning J, Shackcloth M, Batchelor T, et al. Pulmonary metastasectomy in colorectal cancer: updated analysis of 93 randomized patients: control survival is much better than previously assumed. Colorect Dis. 2020;22:1314–24.

    CAS  Article  Google Scholar 

  3. 3.

    Treasure T, Farewell V, Macbeth F, Monson K, Williams NR, Brew-Graves C, et al. Pulmonary Metastasectomy versus Continued Active Monitoring in Colorectal Cancer (PulMiCC): a multicentre randomised clinical trial. Trials. 2019;20:718.

    CAS  Article  Google Scholar 

  4. 4.

    Brew-Graves C, Farewell V, Monson K, Milosevic M, Williams N, Morris E, et al. Pulmonary metastasectomy in colorectal cancer: health utility scores by EQ-5D-3L in a randomised controlled trial show no benefit from lung metastasectomy. Colorect Dis. 2021;23:200–205.

    Article  Google Scholar 

  5. 5.

    Handy JR, Bremner RM, Crocenzi TS, Detterbeck FC, Fernando HC, Fidias PM, et al. Expert consensus document on pulmonary metastasectomy. Ann Thorac Surg. 2019;107:631–49.

    Article  Google Scholar 

  6. 6.

    Macbeth F, Fallowfield L. The myth of pulmonary metastasectomy. Br J Cancer. 2020;123:499–500.

    Article  Google Scholar 

  7. 7.

    Macbeth F, Treasure T. Metastasectomy for sarcoma. Clin Oncol R Coll Radiol. 2015;27:428–9.

    CAS  Article  Google Scholar 

  8. 8.

    Treasure T, Macbeth F. Doubt about effectiveness of lung metastasectomy for sarcoma. J Thorac Cardiovasc Surg. 2015;149:93–4.

    Article  Google Scholar 

  9. 9.

    Treasure T, Moller H, Fiorentino F, Utley M. Forty years on: pulmonary metastasectomy for sarcoma. Eur J Cardiothorac Surg. 2013;43:799–800.

    Article  Google Scholar 

  10. 10.

    Treasure T, Baum M. An approach to randomization into surgical clinical trials. Br J Surg. 2017;104:11–2.

    CAS  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Tom Treasure MD, MS, FRCS, FRCP.

Ethics declarations


Timothy Batchelor received Honoraria from Medtronic, J&J, and Medela. Jurjees Hassan, Fergus Macbeth, Michael Shackcloth and Tom Treasure have no conflicts of interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Batchelor, T., Hasan, J., Macbeth, F. et al. Randomised Controlled Trial Evidence Questions the Assumption that Pulmonary Metastasectomy Benefits Patients with Colorectal Cancer. Ann Surg Oncol (2021). https://doi.org/10.1245/s10434-020-09521-3

Download citation