Management of Advanced Disease – Lung Metastases
plain language summary
Bowel cancer is the fourth most common cancer in the UK. At diagnosis, around 20% of patients (which subsequently increases to 50% of patients) with bowel cancer are told that their cancer has metastasised. This means that the cancer has spread to another part of the body. One place that the cancer often spreads is to the lungs. It is uncommon for the cancer to spread only to the lungs in patients with bowel cancer, with over 80-85% of patients also having metastases in other areas, most commonly the liver.
There are a number of recommendations on what surgical practice should be taken in the NHS when dealing with bowel cancer lung metastases. One such recommendation is a pulmonary metastasectomy which is the surgical removal of tumours in the lungs. Despite this being a recommendation, there does not appear to be any large scale trials looking into the practice of pulmonary metastasectomy.
This study aims to investigate the use of pulmonary metastasectomy in the bowel cancer population across the English NHS and to find the extent of any differences in practice amongst NHS hospitals and differences in outcomes for patients.
What did we do?
All patients with a primary bowel cancer (this means that the cancer originated in the bowel) and who had received surgery to remove the tumour at an NHS hospital between 1 January 2005 and 31 December 2013 were identified. From here, all patients who had then undergone a pulmonary metastasectomy within three years of the original cancer surgery were identified.
What did we find?
2% of patients who had surgery to remove a tumour in the bowel went on to have a pulmonary metastasectomy within three years. The number of patients receiving a pulmonary metastasectomy varied significantly between hospital trusts.
- Publication: Fenton HM, Finan PJ, Milton R, Shackcloth M, Taylor JC, Treasure T, Morris EJA. National variation in pulmonary metastasectomy for colorectal cancer. Colorect Dis 2020
- Conference Presentation: The Association of Coloproctology of Great Britain and Ireland (ACPGBI) Annual Meeting 2020. ‘National Variation in Pulmonary Metastasectomy for Colorectal Cancer’