Lung metastasis surgeries rise as five-year survival improves

The number of operations to remove lung metastases at Landspítali hospital has increased significantly in recent decades, while the proportion of patients alive five years after surgery has also risen, mbl.is reports.

The findings come from a new study by researchers at the University of Iceland and Landspítali, recently published in the scientific journal Scandinavian Journal of Surgery. A metastasis is cancer that has spread from its original location to another organ.

Lung metastases are common in advanced cancer and are generally associated with poorer patient outcomes. Surgery can improve the outlook for some patients, particularly those with a small number of metastases confined to one lung who are suitable for surgery and in good physical condition.

The study, titled “Pulmonary metastasectomy in Iceland: Long-term nationwide trends and outcomes,” examined 179 patients who underwent surgery to remove lung metastases at Landspítali between 2001 and 2021. The researchers divided the period into three seven-year intervals to assess changes in the reasons for surgery and its outcomes.

The number of operations increased significantly over the period, with almost half performed during the final interval. The most common sources of the metastases were colorectal cancer, accounting for 39 percent of cases, renal cell carcinoma at 16 percent, and sarcomas at 10 percent.

Five-year survival improved significantly alongside the increase in operations, rising from 31 percent during the first period to 55 percent during the last. Wedge resection was the most common procedure. Lobectomy was performed on 38 percent of patients, while 3 percent underwent removal of an entire lung. About half of the patients received chemotherapy after surgery.

The researchers said improvements in imaging, including positron emission tomography scans, may have helped doctors identify patients most likely to benefit from surgery. Advances in surgical techniques also played a role, including the introduction of video-assisted thoracic surgery at Landspítali in 2018.

Major advances have also been made in cancer treatment, particularly with the development of biological drugs and immunotherapies.

The study’s first author is Carlos Magnús Rabelo, a fifth-year medical student at the University of Iceland. He conducted the research alongside his medical studies under the supervision of Halla Viðarsdóttir, a colorectal surgeon, and Tómas Guðbjartsson, a professor and cardiothoracic surgeon. Both work at Landspítali.