{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:50:57Z","timestamp":1791805857886,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Patients with single metastases from colorectal cancer constitute a subgroup with an excellent 5-year OS of 55\u201370% and with a real chance for cure. In this situation, local margin recurrence in the lung may impair the prognosis and thus is the main outcome target of surgery. Methods: A retrospective multicenter analysis of patients with single metastases from colorectal cancers was performed. Four German Thoracic Surgery units contributed data from their prospective metastasectomy databases. Statistical analysis was focused on tumor recurrence and risk factors for local margin recurrence. Results: 166 patients from four centers could be further analyzed. For later comparison, 93 (56%) anatomic resections and 73 (44%) non-anatomic resections were pooled. Tumor recurrence was detected: at any site 87\/161 (54%), within the lung 62\/161 (38.5%) at intrapulmonary margins 25\/145 (17.2%) and in intrathoracic lymph nodes 14\/138 (10.1%). Intrapulmonary local margin recurrence was more often found in non-anatomic (25.4%) versus anatomic (11.6%) resections (p = 0.052). After propensity score matching (PSM), local margin recurrence was significantly more frequent after non-anatomic resection of intermediate and peripherally located metastases (p = 0.042). Furthermore, local margin recurrence was associated with small safety margins (p &lt; 0.001), small number of lymph nodes removed (p &lt; 0.001) and with intrathoracic lymph node recurrence (p = 0.001). The 5- and 10-year OS of the whole group was 70% and 47% with a median survival of 9.0 years. The 5- and 10-year RFS of the whole group was 59% and 43% with a median of 7.3 years. Conclusions: This study demonstrates that anatomical resection of single CRC lung metastases is superior to non-anatomic resection with respect to local radicality and local intrapulmonary margin recurrence, but there was no difference in OS and RFS.<\/jats:p>","DOI":"10.3390\/cancers17203299","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T07:51:28Z","timestamp":1760428288000},"page":"3299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pulmonary Metastasectomy: A Multicenter Comparison of Wedge Resection Versus Anatomic Resection for Single Metastases of Colorectal Cancer"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4194-8215","authenticated-orcid":false,"given":"Stefan","family":"Welter","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Lungenklinik Hemer, 58675 Hemer, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Moneke","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramzi","family":"Wara","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Lungenklinik Hemer, 58675 Hemer, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5671-3048","authenticated-orcid":false,"given":"Antonia Uyen-Thao","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Shalabi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, SLK Lungenklinik L\u00f6wenstein, 74245 L\u00f6wenstein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Graeter","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, SLK Lungenklinik L\u00f6wenstein, 74245 L\u00f6wenstein, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Ploenes","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fachkrankenhaus Coswig, Lung Center, 01640 Coswig, Germany"},{"name":"Division of Thoracic Surgery, Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, 01069 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Baum","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fachkrankenhaus Coswig, Lung Center, 01640 Coswig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S1291","DOI":"10.21037\/jtd.2017.03.175","article-title":"Pulmonary metastasectomy: An overview","volume":"9","author":"Petrella","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jss.2025.03.042","article-title":"Surgical Resection of a Single Colorectal Lung Metastasis is Associated with Best Survival","volume":"309","author":"Arunachalam","year":"2025","journal-title":"J. Surg. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0022-5223(97)70397-0","article-title":"Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases","volume":"113","author":"Pastorino","year":"1997","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4197","DOI":"10.21037\/jtd-2022-16","article-title":"Anatomical resection of colorectal lung metastases: A reasonable indication without evidence\u2014Non-systematic and incomplete reporting is a key issue","volume":"14","author":"Welter","year":"2022","journal-title":"J. Thorac. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1097\/SLA.0000000000002829","article-title":"Anatomical Resections Improve Survival Following Lung Metastasectomy of Colorectal Cancer Harboring KRAS Mutations","volume":"270","author":"Renaud","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_6","first-page":"504","article-title":"Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer","volume":"51","author":"Shiono","year":"2016","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1093\/annonc\/mdw064","article-title":"Role of major resection in pulmonary metastasectomy for colorectal cancer in the Spanish prospective multicenter study (GECMP-CCR)","volume":"27","author":"Molins","year":"2016","journal-title":"Ann. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.21037\/jtd-22-239","article-title":"Impact of the extent of lung resection on postoperative outcomes of pulmonary metastasectomy for colorectal cancer metastases: An exploratory systematic review","volume":"14","author":"Prisciandaro","year":"2022","journal-title":"J. Thorac. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/ejcts\/ezx063","article-title":"Growth patterns of pulmonary metastases: Should we adjust resection techniques to primary histology and size?","volume":"52","author":"Welter","year":"2017","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.athoracsur.2018.02.007","article-title":"Pulmonary Metastasectomy for Colorectal Cancer: Predictors of Survival in Routine Surgical Practice","volume":"105","author":"Nanji","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"763","DOI":"10.3389\/fonc.2019.00763","article-title":"Is Adjuvant Chemotherapy Worthwhile After Radical Resection for Single Lung Metastasis from Colorectal Cancer? A Multicentric Analysis Evaluating the Risk of Recurrence","volume":"9","author":"Rapicetta","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.21037\/jovs.2019.03.12","article-title":"Pursuit of an optimal surgical margin in pulmonary metastasectomy","volume":"5","author":"Welter","year":"2019","journal-title":"J. Vis. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"820","DOI":"10.4251\/wjgo.v14.i4.820","article-title":"Management of single pulmonary metastases from colorectal cancer: State of the art","volume":"14","author":"Chiappetta","year":"2022","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.athoracsur.2014.05.023","article-title":"The Prognosis of Pulmonary Metastasectomy Depends on the Location of the Primary Colorectal Cancer","volume":"98","author":"Cho","year":"2014","journal-title":"Ann. Thorac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.athoracsur.2014.09.027","article-title":"Long-Term Outcomes After Surgical Resection of Pulmonary Metastases from Colorectal Cancer","volume":"99","author":"Suzuki","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12957-015-0621-7","article-title":"The prognostic importance of the number of metastases in pulmonary metastasectomy of colorectal cancer","volume":"13","author":"Cho","year":"2015","journal-title":"World J. Surg. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13019-021-01740-3","article-title":"Survival prognostic and recurrence risk factors after single pulmonary metastasectomy","volume":"16","author":"Forster","year":"2021","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.athoracsur.2004.06.096","article-title":"Histopathologic Prognostic Factors in Resected Colorectal Lung Metastases","volume":"79","author":"Shiono","year":"2005","journal-title":"Ann. Thorac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1007\/s11748-020-01368-5","article-title":"Prognosis of patients with recurrence after pulmonary metastasectomy for colorectal cancer","volume":"68","author":"Sakamaki","year":"2020","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1016\/j.athoracsur.2012.07.014","article-title":"Predictors of Recurrent Pulmonary Metastases and Survival After Pulmonary Metastasectomy for Colorectal Cancer","volume":"94","author":"Blackmon","year":"2012","journal-title":"Ann. Thorac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Shalabi, A., Shalabi, S.F., Graeter, T., Welter, S., Ehab, A., and Kuon, J. (2025). Low Rates of Intrapulmonary Local Recurrence After Laser Metastasectomy: A Single-Center Retrospective Cohort Study of Colorectal Cancer Metastases. Cancers, 17.","DOI":"10.3390\/cancers17040683"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1038\/bjc.2014.499","article-title":"KRAS and BRAF mutations are prognostic biomarkers in patients undergoing lung metastasectomy of colorectal cancer","volume":"112","author":"Renaud","year":"2015","journal-title":"Br. J. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/j.jtcvs.2010.08.089","article-title":"Safety distance in the resection of colorectal lung metastases: A prospective evaluation of satellite tumor cells with immunohistochemistry","volume":"141","author":"Welter","year":"2011","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1016\/j.jtcvs.2018.10.156","article-title":"Surgical margins and risk of local recurrence after wedge resection of colorectal pulmonary metastases","volume":"157","author":"Nelson","year":"2019","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Metastatic Lung Tumor Study Group of Japan, Shiono, S., Matsutani, N., Hashimoto, H., Yamauchi, Y., Matsuguma, H., Mun, M., Kuroda, H., Funai, K., and Nakajima, J. (2021). Prospective study of recurrence at the surgical margin after wedge resection of pulmonary metastases. Gen. Thorac. Cardiovasc. Surg., 69, 950\u2013959.","DOI":"10.1007\/s11748-020-01560-7"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.ejso.2021.09.020","article-title":"Pulmonary metastasectomy with lymphadenectomy for colorectal pulmonary metastases: A systematic review","volume":"48","author":"Bousema","year":"2022","journal-title":"Eur. J. Surg. Oncol. (EJSO)"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e36819","DOI":"10.1097\/MD.0000000000036819","article-title":"Prognostic value of circulating tumor cells in patients with recurrent and metastatic colorectal cancer: A systematic review and meta-analysis","volume":"103","author":"Liu","year":"2024","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-018-26410-8","article-title":"Intraoperative detection of circulating tumor cells in pulmonary venous blood during metastasectomy for colorectal lung metastases","volume":"8","author":"Le","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.surg.2022.10.014","article-title":"Prognostic differences between oligometastatic and polymetastatic disease after resection in patients with colorectal cancer and hepatic or lung metastases: Retrospective analysis of a large cohort at a single institution","volume":"173","author":"Horie","year":"2022","journal-title":"Surgery"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00384-017-2768-x","article-title":"Prognosis of video-assisted thoracoscopic pulmonary metastasectomy in patients with colorectal cancer lung metastases: An analysis of 154 cases","volume":"32","author":"Sun","year":"2017","journal-title":"Int. J. Color. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1287088","DOI":"10.3389\/fonc.2023.1287088","article-title":"Segmentectomy for patients with early-stage pure-solid non-small cell lung cancer","volume":"13","author":"Kamigaichi","year":"2023","journal-title":"Front. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.chest.2023.11.042","article-title":"Recurrence-Free Survival in Patients with Surgically Resected Non-Small Cell Lung Cancer","volume":"165","author":"Rajaram","year":"2023","journal-title":"Chest"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/20\/3299\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T08:02:46Z","timestamp":1760428966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/20\/3299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,11]]},"references-count":32,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["cancers17203299"],"URL":"https:\/\/doi.org\/10.3390\/cancers17203299","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,11]]}}}