Chiappetta M, Salvatore L, Congedo MT, Bensi M, De Luca V, Petracca Ciavarella L, Camarda F, Evangelista J, Valentini V, Tortora G, Margaritora S, Lococo F. Management of single pulmonary metastases from colorectal cancer: State of the art. World J Gastrointest Oncol 2022; 14(4): 820-832 [PMID: 35582100 DOI: 10.4251/wjgo.v14.i4.820]
Corresponding Author of This Article
Filippo Lococo, MD, Assistant Professor, Department of Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome 00168, Italy. filippo.lococo@policlinicogemelli.it
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Apr 15, 2022; 14(4): 820-832 Published online Apr 15, 2022. doi: 10.4251/wjgo.v14.i4.820
Management of single pulmonary metastases from colorectal cancer: State of the art
Marco Chiappetta, Lisa Salvatore, Maria Teresa Congedo, Maria Bensi, Viola De Luca, Leonardo Petracca Ciavarella, Floriana Camarda, Jessica Evangelista, Vincenzo Valentini, Giampaolo Tortora, Stefano Margaritora, Filippo Lococo
Marco Chiappetta, Maria Teresa Congedo, Leonardo Petracca Ciavarella, Jessica Evangelista, Stefano Margaritora, Filippo Lococo, Department of Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 00168, Italy
Lisa Salvatore, Maria Bensi, Floriana Camarda, Giampaolo Tortora, Oncologia Medica Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 00168, Italy
Viola De Luca, Vincenzo Valentini, Department of Radiation Therapy, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 00168, Italy
Author contributions: Chiappetta M wrote the paper; Congedo MT, Petracca Ciavarella L, Bensi M, De Luca V and Camarda F collected the bibliography and supported manuscript drafting; Evangelista J supported manuscript drafting; Salvatore L and Lococo F revised and edited the manuscript; Margaritora S, Tortorta G and Valentini V supervised the manuscript.
Conflict-of-interest statement: No conflict-of-interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Filippo Lococo, MD, Assistant Professor, Department of Thoracic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome 00168, Italy. filippo.lococo@policlinicogemelli.it
Received: March 26, 2021 Peer-review started: March 26, 2021 First decision: May 3, 2021 Revised: May 26, 2021 Accepted: March 4, 2022 Article in press: March 4, 2022 Published online: April 15, 2022
Abstract
Colorectal cancer (CRC) is one of the most common causes of death from cancer. Lung seeding occurs in approximately 10% of patients surgically treated for primary CRC with radical intent: the lung is the most common site of metastases after the liver. While surgical treatment of liver metastases is widely accepted to affect long-term outcomes, more controversial and not standardized is the therapy for CRC patients developing lung metastases. Experience suggests the potential curative role of pulmonary metastasectomy, especially in oligometastatic disease. However, the optimal strategy of care and the definition of prognostic factors after treatment still need to be defined. This review focused on the uncommon scenario of single pulmonary metastases from CRC. We explored pertinent literature and provide an overview of the epidemiology, clinical characteristics and imaging of single pulmonary metastases from CRC. Additionally, we identified the best available evidence for overall management. In particular, we analyzed the role and results of locoregional approaches (surgery, radiotherapy or ablative procedures) and their integration with systemic therapy.
Core Tip: Single pulmonary metastasis from colorectal cancer is an uncommon scenario in which diagnostic pitfalls should be considered. Locoregional approaches (surgery more than radiotherapy or ablative procedures) might have a potential curative role with rewarding long-term results. However, since recurrences are common, the best long-term results might be expected by integrating loco-regional with systemic treatment. Moreover, despite limited evidence, different factors seem to influence prognosis in this subset of patients and should be considered when planning a tailored care strategy.
