Abstract
BACKGROUND: The survival benefits of pulmonary metastasectomy (PM) in colorectal cancer (CRC) patients with pulmonary metastasis remain controversial. This study aimed to assess the survival effect of PM on CRC patients with pulmonary metastasis. METHODS: Data from CRC patients with pulmonary metastasis were collected from the Surveillance, Epidemiology, and End Results database between 2010 and 2020. A 1:1 propensity score matching (PSM) analysis was employed to minimize heterogeneity between the groups. Kaplan-Meier analysis was performed to evaluate the overall survival (OS) of CRC patients with pulmonary metastasis who underwent PM. RESULTS: A total of 1,399 CRC patients with pulmonary metastasis were included; 140 patients and 1,259 patients underwent PM and did not, respectively. After PSM, there were 140 patients in each group. Patients who underwent PM demonstrated a longer median OS than those who did not, in both the overall cohort and the PSM cohort. In the PSM cohort, the median OS was 51 months (95% confidence interval [CI], 45-64 months) for CRC patients with pulmonary metastasis who underwent PM and 36 months (95% CI, 31-42 months) for those who did not undergo PM. Additionally, Cox proportional hazard models indicated that PM was a significant protective factor for OS in CRC patients with pulmonary metastasis (hazard ratio: 0.57; 95% CI, 0.41-0.80, P < 0.01). CONCLUSION: PM prolongs the survival of CRC patients with pulmonary metastasis.