ArticleInternational journal of colorectal disease2025
Neoadjuvant therapy for resectable colorectal cancer pulmonary oligometastases: a retrospective cohort study.
Article in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Pulmonary metastasectomy in colorectal cancer: the importance of interpreting neoadjuvant strategies in the era of modern systemic therapy.International journal of colorectal disease · 2026Article
- Future directions of image-guided thermal ablation in colorectal cancer lung oligometastases.World journal of gastroenterology · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
purposeLung metastasectomy has been considered the cornerstone of treatment of resectable colorectal cancer pulmonary oligometastases (CRCPOM). However, the role of chemotherapy in the neoadjuvant setting remains unclear. This study aimed to determine whether neoadjuvant therapy (NAT) could further improve survival outcomes of patients with resectable CRCPOM.
methodsWe included all 253 consecutive patients at our center between 2010 and 2022. Propensity score matching (PSM) was performed to balance the baseline characteristics. The efficacy of NAT was evaluated using the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1). Disease-free survival (DFS) was the primary endpoint, which was estimated by the Kaplan-Meier method. Multivariate analyses were conducted using Cox proportional hazards regression to identify independent predictors.
resultsThe cumulative 5- and 10-year DFS rates following lung metastasectomy were 48.3% and 39.4%, respectively. After PSM, NAT was significantly associated with improved DFS (HR, 0.52; P = 0.009). A clinical risk score was constructed using four independent predictors of worse DFS (serum carcinoembryonic antigen > 5.0 ng/mL, disease-free interval after colorectal resection < 2 years, primary tumor with nodal involvement, extrapulmonary metastases) and enabled risk stratification. The administration of NAT could improve DFS in patients with ≥ 1 risk factor (HR, 0.60; P = 0.020), while such benefit was not observed in those with no risk factor. RECIST-defined response was noted in 34/74 (46.0%) patients who received NAT, which was correlated with improvement in DFS (HR, 0.31; P = 0.008).
conclusionsNAT may confer a survival benefit in patients with resectable CRCPOM. Using an easy-to-use clinical risk score, patients with ≥ 1 risk factor are good candidates for initial NAT. The RECIST criteria are deemed suitable for the assessment of efficacy of NAT before lung metastasectomy.
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