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Review
. 2019 Feb 14;12(1):16.
doi: 10.1186/s13045-019-0702-0.

Expert consensus on multidisciplinary therapy of colorectal cancer with lung metastases (2019 edition)

Jian Li  1 , Ying Yuan  2 , Fan Yang  3 , Yi Wang  3 , Xu Zhu  1 , Zhenghang Wang  1 , Shu Zheng  2 , Desen Wan  4 , Jie He  5 , Jianping Wang  6 , Yi Ba  7 , Chunmei Bai  8 , Li Bai  9 , Wei Bai  10 , Feng Bi  11 , Kaican Cai  12 , Muyan Cai  4 , Sanjun Cai  13 , Gong Chen  4 , Keneng Chen  1 , Lin Chen  9 , Pengju Chen  1 , Pan Chi  14 , Guanghai Dai  9 , Yanhong Deng  6 , Kefeng Ding  2 , Qingxia Fan  15 , Weijia Fang  16 , Xuedong Fang  17 , Fengyi Feng  5 , Chuangang Fu  18 , Qihan Fu  2 , Yanhong Gu  19 , Yulong He  20 , Baoqing Jia  9 , Kewei Jiang  3 , Maode Lai  21 , Ping Lan  6 , Enxiao Li  22 , Dechuan Li  23 , Jin Li  18 , Leping Li  24 , Ming Li  1 , Shaolei Li  1 , Yexiong Li  5 , Yongheng Li  1 , Zhongwu Li  1 , Xiaobo Liang  10 , Zhiyong Liang  8 , Feng Lin  6 , Guole Lin  8 , Hongjun Liu  24 , Jianzhong Liu  7 , Tianshu Liu  25 , Yunpeng Liu  26 , Hongming Pan  27 , Zhizhong Pan  4 , Haiping Pei  28 , Meng Qiu  11 , Xiujuan Qu  26 , Li Ren  25 , Zhanlong Shen  3 , Weiqi Sheng  13 , Chun Song  18 , Lijie Song  16 , Jianguo Sun  29 , Lingyu Sun  30 , Yingshi Sun  1 , Yuan Tang  5 , Min Tao  31 , Chang Wang  32 , Haijiang Wang  33 , Jun Wang  3 , Shubin Wang  34 , Xicheng Wang  1 , Xishan Wang  5 , Ziqiang Wang  11 , Aiwen Wu  1 , Nan Wu  1 , Lijian Xia  35 , Yi Xiao  8 , Baocai Xing  1 , Bin Xiong  36 , Jianmin Xu  25 , Jianming Xu  37 , Nong Xu  16 , Ruihua Xu  4 , Zhongfa Xu  38 , Yue Yang  1 , Hongwei Yao  39 , Yingjiang Ye  3 , Yonghua Yu  40 , Yueming Yu  41 , Jinbo Yue  40 , Jingdong Zhang  42 , Jun Zhang  43 , Suzhan Zhang  2 , Wei Zhang  44 , Yanqiao Zhang  45 , Zhen Zhang  13 , Zhongtao Zhang  39 , Lin Zhao  8 , Ren Zhao  43 , Fuxiang Zhou  36 , Jian Zhou  25 , Jing Jin  46 , Jin Gu  47 , Lin Shen  48
Affiliations
Review

Expert consensus on multidisciplinary therapy of colorectal cancer with lung metastases (2019 edition)

Jian Li et al. J Hematol Oncol. .

Abstract

The lungs are the second most common site of metastasis for colorectal cancer (CRC) after the liver. Rectal cancer is associated with a higher incidence of lung metastases compared to colon cancer. In China, the proportion of rectal cancer cases is around 50%, much higher than that in Western countries (nearly 30%). However, there is no available consensus or guideline focusing on CRC with lung metastases. We conducted an extensive discussion and reached a consensus of management for lung metastases in CRC based on current research reports and the experts' clinical experiences and knowledge. This consensus provided detailed approaches of diagnosis and differential diagnosis and provided general guidelines for multidisciplinary therapy (MDT) of lung metastases. We also focused on recommendations of MDT management of synchronous lung metastases and initial metachronous lung metastases. This consensus might improve clinical practice of CRC with lung metastases in China and will encourage oncologists to conduct more clinical trials to obtain high-level evidences about managing lung metastases.

Keywords: China; Colorectal cancer; Consensus; Lung metastases; Multidisciplinary therapy.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Principles of treatment for lung metastases. Note 1: Number sign is patients with primary tumor or local recurrence. If the primary tumor or local recurrence that cannot be radically treated initially, reassess the possibility of radical treatment after (intensive) systemic therapy: (1) if the lesion has converted to a curable tumor, then the above process can be used as a reference; (2) if the tumor is still incurable, a comprehensive therapy protocol should be formulated after multidisciplinary discussion (in such cases, the lesion could be managed as “an incurable metastatic lesion”). Note 2: For lung metastases + extrapulmonary metastases at any site other than the liver, please refer to the treatment principles for “lung metastases + liver metastases.” Note 3: Non-initial lung metastases are a highly heterogenous group of diseases. In contrast to initial lung metastases, these patients have previously received drug treatment, and further drug efficacy is relatively low. For these patients, it is recommended that a final decision be made after the MDT team has comprehensively examined the patient’s physical status, efficacy and adverse events from previous treatment, drug discontinuation duration, and the biological behavior of tumors
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