Evidence map›Paper›PMID 39844651›Full record

SynthesisColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2025

Multimodal treatment improves survival in patients with lung metastases from colorectal cancer: A network meta-analysis.

Andrea Chierici, Danilo Vinci, Guido Liddo, Stefano Granieri, Mauro Loi, Marco Alifano, Antonio Iannelli

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Multimodal treatment improves survival in patients with lung metastases from colorectal cancer: A network meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andrea ChiericiDigestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France.ORCID 0000-0003-1475-4500
Danilo VinciDigestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France.ORCID 0000-0002-8215-5756
Guido LiddoDigestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France.
Stefano GranieriGeneral Surgery Department, Ospedale di Vimercate, ASST Della Brianza, Vimercate, Italy.
Mauro LoiRadiotherapy Department Azienda Universitaria Ospedaliera Careggi, Università Degli Studi di Firenze, Florence, Italy.
Marco AlifanoThoracic Surgery Department, Cochin Hospital, APHP Centre, University of Paris, Paris, France.
Antonio IannelliDigestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe lungs represent the second most common site of colorectal cancer metastases. Although surgery is commonly considered the best treatment, many other invasive and noninvasive procedures and treatments have been adopted to improve patient survival and there is no clear evidence in the literature of which is the more effective. The aim of this work was to identify which treatment confers the best gain in overall survival for patients with pulmonary metastases from colorectal cancer.

methodA systematic review and network meta-analysis of survival hazard ratio (HR) including 11 studies was conducted following the PRISMA guidelines and the Cochrane protocol on PubMed, Scopus, Embase, Web of Science and Cochrane Library up to 31 December 2023. Surgery, image-guided thermoablation, stereotactic body radiotherapy, chemotherapy and best standard care, associated or alone, were evaluated. Chemotherapy was adopted as the treatment reference to define survival HRs. Network metaregression was then performed considering patients with pulmonary only or multisite metastases from colorectal cancer.

resultsIn patients with pulmonary metastases, the association of surgery, stereotactic body radiotherapy and chemotherapy is the best performing (HR 0.22), while the most effective components alone are image-guided thermoablation (HR 0.53) and surgery (HR 0.57), although this was not significant. After metaregression, multimodal treatments still represent the strategy conferring the best survival gain. However, while surgery (incremental HR 0.26) has the most important role in patients with isolated pulmonary metastatic disease, chemotherapy (incremental HR 0.3) leads for patients with multimetastatic disease.

conclusionMultimodal treatment confers the best gain in overall survival in patients with pulmonary metastases from colorectal cancer. Combining multiple therapeutic strategies improves survival, with oligometastatic patients benefiting more from surgery and local therapies while multimetastatic patients mainly benefit from chemotherapy, although ablation and surgery can enhance outcomes when feasible.

Indexed as

Colorectal NeoplasmsLung NeoplasmsAgedCombined Modality TherapyFemaleHumansMaleMiddle AgedRadiosurgerySurvival AnalysisTreatment Outcomechemotherapycolorectal cancerimaging‐guided thermoablationmeta‐analysispulmonary metastasesradiotherapysurgerysurvival

Identifiers

PMID39844651
PMCPMC11754994

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.