Correspondence for the article titled - Prognostic impact of metastatic sites and its metastasectomy in colorectal cancer

Sep 30, 2026

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Correspondence discussing a retrospective single-institution analysis on metastatic colorectal cancer outcomes by metastatic site and metastasectomy. The authors highlight improved overall survival after surgical resection for resectable liver, lung, and distant lymph-node metastases, with less benefit in peritoneal disease. The letter emphasizes surgery’s potential to remove site-based survival disparities, notes favourable results in pulmonary metastases, and compares findings with ablative approaches. Limitations are raised for missing data on margin status and HIPEC usage, while future work is urged using molecular markers and standardized perioperative strategies, including ctDNA.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Correspondence overview

Reported survival impact by metastatic site

Pulmonary metastases and surgical approaches

Limitations and future research directions

International Journal of Colorectal Disease (2026) 41:17 [https://doi.org/10.1007/s00384-025-05077-4](https://doi.org/10.1007/s00384-025-05077-4) Correspondence for the article titled –“Prognostic impact of metastatic sites and its metastasectomy in colorectal cancer: a retrospective analysis from a single institution” Mohit Bhatia1 · Danko Kostadinov1 Received: 3 September 2025 / Accepted: 30 December 2025 © The Author(s) 2026 We read with great interest the article by Huang et al. [1] exploring the prognostic implications of metastatic site and metastasectomy in patients with metastatic colorectal cancer (mCRC) . The authors provide compelling evidence that surgical resection significantly improves overall survival inpatients with resectable liver, lung, and distant lymph node metastases, but offers less benefit in cases of peritoneal metastases. The strength of this study is its large, single-institution cohort with detailed stratification of outcomes by site-specific metastasectomy. The finding that surgery can eliminate site-based survival disparities—except in peritoneal disease—provides valuable guidance for clinical decisionmaking and MDT planning. It is notable that this study reports favourable outcomesin patients with pulmonary metastases who underwent surgical resection. Similar findings were demonstrated by Shishido et al., reinforcing that surgical intervention offers particular benefit in patients with a limited pulmonary metastatic burden, good performance status, controlled primary disease, and no uncontrolled extra-thoracic spread. Their work also highlighted several prognostic factors associated with improved postoperative survival, including the ability to achieve an R0 resection, a small number of metastatic lesions, a longer disease-free interval, and favourable tumour biology. In addition, minimally invasive techniques such as VATS were shown to reduce perioperative morbidity and allow for repeat resections when necessary [2] . Traiki et al. [3] highlighted the role of ablative procedures in the management of pulmonary metastases in patients with colorectal cancer. Their study demonstrated a significant * Mohit Bhatia [drbhatia711@gmail.com](drbhatia711@gmail.com) 1 Department of General & Colorectal Surgery, Princess Royal University Hospital, Orpington, King’s College, London, UK overall survival advantage compared with patients treated with systemic therapy alone. However, the absence of data on surgical margin status and HIPEC usage limits the interpretation of peritoneal metastases outcomes. Future prospective studies integrating molecular markers and standardized perioperative strategies could further clarify these findings. Incorporating RAS, BRAF, and MSI status into future prospective analyses could optimize surgical selection and enhance prognostic accuracy [4] . We concur with the results of this retrospective analysis, which support the use of cytoreductive surgery (CRS) and metastasectomy without HIPEC. Nevertheless, the prognostic significance is still uncertain, and further research, particularly incorporating circulating tumour DNA (ctDNA) analysis, is needed. Author contributions Contributor 1 (MB) -Designed the research and performed the statistical analysis, manuscript formation, editing of the manuscript. Contributor 2 (DK)– editing of the manuscript, analysis. Funding No funding received. Data availability This manuscript does not report data generation or analysis. Declarations Prior publication Nil Permission Nil Competing interests The authors declare no competing interests. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and

FAQs

What survival benefit does the correspondence discuss for surgical resection?

Surgical resection is described as significantly improving overall survival for resectable liver, lung, and distant lymph-node metastases, while offering less benefit for peritoneal metastases.

How does the letter characterize outcomes for pulmonary metastases?

It reports favourable outcomes for patients with pulmonary metastases undergoing surgical resection and notes that benefit is linked to factors such as limited metastatic burden and absence of uncontrolled extra-thoracic spread.

What key limitations and research needs are identified?

Interpretation of peritoneal metastasis outcomes is limited by missing data on surgical margin status and HIPEC usage; the correspondence calls for prospective studies incorporating molecular markers and standardized perioperative strategies, including ctDNA analysis.

Sep 30, 2026

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