The Therapeutic Effectiveness of Segmental Lung Resection Versus Lobectomy in Patients With Isolated Lung Metastases From Colorectal Cancer: Evidence From a Retrospective Cohort Study

Introduction: In patients with solitary pulmonary metastasis from colorectal cancer, surgical resection is considered a standard treatment protocol and is routinely performed in thoracic surgery. However, there is a paucity of studies that delve into the detailed discussion of the efficacy and safety of lobectomy and segmentectomy in the treatment of pulmonary metastatic cancer. Our study retrospectively analyzed the surgical outcomes of 62 patients from a single center and reported the findings. Methods: A retrospective analysis was meticulously conducted on a cohort of 62 patients who underwent either lung segmental resection ( n = 31) or lobectomy ( n = 31) for isolated lung metastases at the department of thoracic surgery of Gansu Provincial People’s Hospital, spanning a decade from September 2015 to September 2024. The surgical data were thoroughly examined, encompassing perioperative details and patient outcomes. Results: Both surgical approaches achieved successful resection of colorectal cancer lung metastases, without any perioperative mortality reported. In comparison to the group undergoing lung segmental resection, the cohort receiving lobectomy exhibited significantly larger tumor diameters ( p < 0.001), prolonged operative durations ( p < 0.001), increased intraoperative bleeding ( p = 0.002), augmented drainage volume on the first postoperative day ( p < 0.001), greater total postoperative drainage ( p < 0.001), and elevated operative costs ( p < 0.001). However, there were no statistically significant differences between the two groups regarding postoperative pain scores ( p = 0.755), time to postoperative extubation ( p = 0.744), time to postoperative ambulation ( p = 0.742), duration of postoperative hospital stay ( p = 0.870), lymph node metastasis ( p = 0.671), postoperative complications ( p = 0.562), survival rate ( p = 0.550), recurrence‐free survival rate ( p = 0.450), and cumulative incidence ( p = 0.321). Conclusions: Pulmonary segmentectomy offers superior advantages in terms of operative time, intraoperative blood loss, drainage volume on the first postoperative day, total postoperative drainage volume, and surgical costs.