The Relationship Between Primary Colorectal Cancer Tumour Characteristics and Patient Outcomes Following Surgery for Oligometastatic Pulmonary Metastases: A Single-Centre Retrospective Study.
4 affiliations
- 1Colorectal & Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester M20 4BX, UK.
- 2Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester M23 9LT, UK.
- 3Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK.
- 4Department of Thoracic Oncology, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester M23 9LT, UK.
Abstract
Background: Colorectal cancer (CRC) is the third most common cancer globally. Approximately 20% present with metastatic disease, most commonly to the liver and lung. Pulmonary metastasectomy (PM) is the most considered therapeutic option for oligometastatic colorectal lung metastases, though evidence is predominantly retrospective. This study aims to understand the relationship between primary colorectal cancer tumour characteristics and survival in patients undergoing PM. Methods: This single-centre retrospective study included 372 consecutive patients undergoing PM at Manchester University Foundation Trust (2011-2021). Data was extracted from prospectively maintained clinical databases. Overall survival was calculated from the date of PM. Kaplan-Meier log-rank and Cox proportional hazards regression analyses identified prognostic factors. Results: Two-thirds of the patients included were over the age of 65 (65%), and 63% were male. The median follow-up was 48 months, with a median survival of 69 months. On univariate analysis, age ≥ 65, advanced TNM, T stage, right-sided primary tumour location, lymphovascular invasion, and KRAS mutation were associated with reduced overall survival. Upon multivariate analysis, age ≥ 65 (HR 2.60, 95% CI 1.14-5.91, p = 0.023) and lymph node yield ≥ 12 (HR 0.38, 95% CI 0.17-0.83, p = 0.016) were independently associated with survival. Conclusions: Primary tumour characteristics are important determinants of outcomes after PM. Older age, right-sided primary tumour location, inadequate lymph node yield and KRAS mutation are associated with survival, highlighting the need for refined patient selection. These findings support integrating clinical, pathological, and molecular factors to aid decision-making in patients with colorectal pulmonary metastases.
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BibTeX
@article{asad2026relationship,
title = {{The Relationship Between Primary Colorectal Cancer Tumour Characteristics and Patient Outcomes Following Surgery for Oligometastatic Pulmonary Metastases: A Single-Centre Retrospective Study.}},
author = {Anam Asad and Marcus Taylor and Thomas Craze and David Woolf and Gokul Raj Krishna and Sayan Biswas and Asmita Singhania and Matt Evison and Kandadai Rammohan and Omer Aziz and Meera Patel},
journal = {Cancers},
year = {2026},
month = sep,
doi = {10.3390/cancers18193080},
url = {https://europepmc.org/article/MED/42882775},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Relationship Between Primary Colorectal Cancer Tumour Characteristics and Patient Outcomes Following Surgery for Oligometastatic Pulmonary Metastases: A Single-Centre Retrospective Study.
AU - Anam Asad
AU - Marcus Taylor
AU - Thomas Craze
AU - David Woolf
AU - Gokul Raj Krishna
AU - Sayan Biswas
AU - Asmita Singhania
AU - Matt Evison
AU - Kandadai Rammohan
AU - Omer Aziz
AU - Meera Patel
PY - 2026
DA - 2026/09/22
JO - Cancers
DO - 10.3390/cancers18193080
UR - https://europepmc.org/article/MED/42882775
AB - Background: Colorectal cancer (CRC) is the third most common cancer globally. Approximately 20% present with metastatic disease, most commonly to the liver and lung. Pulmonary metastasectomy (PM) is the most considered therapeutic option for oligometastatic colorectal lung metastases, though evidence is predominantly retrospective. This study aims to understand the relationship between primary colorectal cancer tumour characteristics and survival in patients undergoing PM. Methods: This single-centre retrospective study included 372 consecutive patients undergoing PM at Manchester University Foundation Trust (2011-2021). Data was extracted from prospectively maintained clinical databases. Overall survival was calculated from the date of PM. Kaplan-Meier log-rank and Cox proportional hazards regression analyses identified prognostic factors. Results: Two-thirds of the patients included were over the age of 65 (65%), and 63% were male. The median follow-up was 48 months, with a median survival of 69 months. On univariate analysis, age ≥ 65, advanced TNM, T stage, right-sided primary tumour location, lymphovascular invasion, and KRAS mutation were associated with reduced overall survival. Upon multivariate analysis, age ≥ 65 (HR 2.60, 95% CI 1.14-5.91, p = 0.023) and lymph node yield ≥ 12 (HR 0.38, 95% CI 0.17-0.83, p = 0.016) were independently associated with survival. Conclusions: Primary tumour characteristics are important determinants of outcomes after PM. Older age, right-sided primary tumour location, inadequate lymph node yield and KRAS mutation are associated with survival, highlighting the need for refined patient selection. These findings support integrating clinical, pathological, and molecular factors to aid decision-making in patients with colorectal pulmonary metastases.
SN - 2072-6694
ER -