Pulmonary laser-assisted metastasectomy is associated with prolonged survival in patients with colorectal cancer

About half of the patients with colorectal cancer develop distant metastases over time, with the liver being the most common site, followed by the lungs. Despite rapid progress being made regarding the effectiveness of chemotherapy and immune therapy, complete surgical resection still remains the only hope for long-term survival for these patients (1). Numerous retrospective analyses have been conducted since the hallmark study of the International Registry of Lung Metastases, which demonstrated that pulmonary metastasectomy can potentially be a curative treatment (2). To date pulmonary metastasectomy for colorectal cancer is performed with curative intent in many institutions, yet clinical practice varies widely due to the lack of randomized data (3). According to a meta-analysis published in 2013, the 5-year survival for patients with completely resected pulmonary metastases from colorectal cancer ranges from 27–68% (4). Several factors have been found to associate with prolonged disease-free survival, such as primary tumor histopathology, the number, size and site of metastases as well as a long progression-free interval between successful treatment of the primary cancer and pulmonary metastasectomy (4). However, randomized controlled trials that help to select the patients who are most likely to benefit from surgery are still lacking