TY - JOUR
T1 - Anatomical Versus Non-Anatomical Pulmonary Metastasectomy
T2 - European Multicentre Analysis
AU - Prisciandaro, Elena
AU - Bertolaccini, Luca
AU - Fieuws, Steffen
AU - Cara, Andrea
AU - Spaggiari, Lorenzo
AU - Huang, Lin
AU - Petersen, René H.
AU - Lucchi, Marco
AU - Mastromarino, Maria G.
AU - Barbarossa, Annalisa
AU - De Leyn, Paul
AU - Roffinella, Matteo
AU - Ruffini, Enrico
AU - Donlagic, Abid
AU - Gonzalez, Michel
AU - Fuentes-Gago, Marta G.
AU - Forcada-Barreda, Clara
AU - Congedo, Maria T.
AU - Margaritora, Stefano
AU - Belaroussi, Yaniss
AU - Thumerel, Matthieu
AU - Tricard, Jérémy
AU - Felix, Pierre
AU - Lebeda, Nina
AU - Opitz, Isabelle
AU - De Palma, Angela
AU - Marulli, Giuseppe
AU - Braggio, Cesare
AU - Thomas, Pascal A.
AU - Mbadinga, Frankie
AU - Baste, Jean Marc
AU - Sayan, Bihter
AU - Yildizeli, Bedrettin
AU - Dekervel, Jeroen
AU - Van Raemdonck, Dirk E.
AU - Weder, Walter
AU - Ceulemans, Laurens J.
N1 - Publisher Copyright:
© 2026 by the authors.
PY - 2026/3
Y1 - 2026/3
N2 - Objectives: Pulmonary metastasectomy is not a standardised procedure, with no consensus regarding the optimal extent of lung resection. This international multicentre study aimed at comparing short and long-term outcomes of anatomical versus non-anatomical pulmonary metastasectomy. Methods: Retrospective database including 1647 patients aged ≥18 years, who underwent curative intent pulmonary metastasectomy between January 2010 and December 2018 at 15 European centres. Patients who underwent pneumonectomy, previous metastasectomies, and/or suffered from extrapulmonary recurrence at the time of lung surgery were excluded. Primary endpoint was overall survival. Secondary endpoints were recurrence-free survival and 30-day morbidity. Differences between the two groups were analysed using 3:1 matching. Results: In the matched cohort, 324 patients underwent anatomical resection, and 830 patients underwent non-anatomical resection. Five-year overall survival was 62.0%. Averaged over the entire follow-up, there was no significant difference in overall survival between the two groups (HR = 1.122, 95% CI = 0.909–1.385, p = 0.283). In the early period following pulmonary metastasectomy, anatomical resections were associated with worse overall survival (HR = 1.549, 95% CI = 1.135–2.114, p = 0.006). The difference in any-site recurrence-free survival between the two groups was not significant (HR = 0.832, 95% CI = 0.690–1.002, p = 0.053). Locoregional recurrence-free survival was significantly longer after anatomical resection (HR = 0.651, 95% CI = 0.520–0.817, p < 0.001). Thirty-day morbidity was significantly higher after anatomical resection (22.2% versus 13.7% for non-anatomical resections, p = 0.001). Conclusions: In a highly selected cohort, non-anatomical resection showed comparable survival and lower morbidity compared to anatomical resections, supporting the surgical strategy of favouring limited resections whenever technically and oncologically feasible. Anatomical resections remain a valid option in selected cases with acceptable outcomes.
AB - Objectives: Pulmonary metastasectomy is not a standardised procedure, with no consensus regarding the optimal extent of lung resection. This international multicentre study aimed at comparing short and long-term outcomes of anatomical versus non-anatomical pulmonary metastasectomy. Methods: Retrospective database including 1647 patients aged ≥18 years, who underwent curative intent pulmonary metastasectomy between January 2010 and December 2018 at 15 European centres. Patients who underwent pneumonectomy, previous metastasectomies, and/or suffered from extrapulmonary recurrence at the time of lung surgery were excluded. Primary endpoint was overall survival. Secondary endpoints were recurrence-free survival and 30-day morbidity. Differences between the two groups were analysed using 3:1 matching. Results: In the matched cohort, 324 patients underwent anatomical resection, and 830 patients underwent non-anatomical resection. Five-year overall survival was 62.0%. Averaged over the entire follow-up, there was no significant difference in overall survival between the two groups (HR = 1.122, 95% CI = 0.909–1.385, p = 0.283). In the early period following pulmonary metastasectomy, anatomical resections were associated with worse overall survival (HR = 1.549, 95% CI = 1.135–2.114, p = 0.006). The difference in any-site recurrence-free survival between the two groups was not significant (HR = 0.832, 95% CI = 0.690–1.002, p = 0.053). Locoregional recurrence-free survival was significantly longer after anatomical resection (HR = 0.651, 95% CI = 0.520–0.817, p < 0.001). Thirty-day morbidity was significantly higher after anatomical resection (22.2% versus 13.7% for non-anatomical resections, p = 0.001). Conclusions: In a highly selected cohort, non-anatomical resection showed comparable survival and lower morbidity compared to anatomical resections, supporting the surgical strategy of favouring limited resections whenever technically and oncologically feasible. Anatomical resections remain a valid option in selected cases with acceptable outcomes.
KW - lung metastasectomy
KW - lung metastases
KW - overall survival
KW - pulmonary metastasectomy
KW - pulmonary metastases
KW - recurrence-free survival
UR - https://www.scopus.com/pages/publications/105037602113
U2 - 10.3390/cancers18061037
DO - 10.3390/cancers18061037
M3 - Journal article
C2 - 41899637
AN - SCOPUS:105037602113
SN - 2072-6694
VL - 18
JO - Cancers
JF - Cancers
IS - 6
M1 - 1037
ER -