A study of patients with metastatic, lung-limited colorectal cancer (CRC) has revealed factors associated with undergoing pulmonary metastasectomy.
Patients who were younger, treated further from home, and/or received care at high-volume centers were more likely to undergo pulmonary metastasectomy. The study also showed that patients who underwent pulmonary metastasectomy had superior overall survival.
These findings were presented in a poster at the American Association for Thoracic Surgery (AATS) Annual Meeting.
The study included 5731 patients with metastatic, lung-limited CRC who were treated between 2010 and 2016. Patients who received primary resection and pulmonary metastasectomy (n=867) were compared to those who only underwent resection of the primary tumor (n=4864).
In unadjusted analyses, patients in the pulmonary metastasectomy group were:
- Younger (median age, 60 years vs 63 years; P <.001)
- More likely to have private insurance (49% vs 38%; P <.001)
- More educated (P <.001)
- More likely to travel 25 miles or more for care (31% vs 20%; P <.001).
In multivariate analyses, factors significantly associated with receipt of pulmonary metastasectomy were younger age, traveling more than 25 miles for treatment, and receiving care at a high-volume center (P <.01 for all).
When the researchers adjusted for patient, tumor, and hospital-related factors, they found that primary site surgery without pulmonary metastasectomy was associated with worse overall survival (hazard ratio, 1.35; 95% CI, 1.23-1.49).
These results emphasize “the strong need for efforts to provide uniform, equitable care to all patients,” the researchers concluded.
Antonoff M, Kui N, Sun R, Rajaram R. Factors associated with receipt of pulmonary metastasectomy in patients with lung-limited metastatic colorectal cancer: Disparities in care and impact on overall survival. Presented at AATS 2023. May 6-9, 2023. Abstract PS56.