A Randomised trial of Pulmonary Metastasectomy in Colorectal Cancer (PuLMiCC)
Principal Investigator: Professor Lesley Fallowfield
Clinical Trial CI: Professor Tom Treasure
Trial Coordinator: Kathryn Monson
Funded by Cancer Research UK
The increasing use of CT scans in routine follow up of colorectal cancer patients has led to earlier diagnosis of isolated and/or subclinical lung nodules. A recent survey on surgeons’ decision making highlighted wide variation in the types of patients considered for pulmonary metastasectomy. This variation is almost certainly due to a lack of evidence regarding which types of patients benefit from it. The survey showed that there are groups of patients where consensus exists on the decision whether or not to operate but many patients fall into the category where wide variation, ie. clinical uncertainty, exists. This trial aims to investigate the outcome following pulmonary metastasectomy in this group of patients, to provide reliable evidence to guide surgeons in the future.
Colorectal cancer patients presenting with pulmonary metastases will firstly be consented for registration into the study. They will provide consent for evaluation according to the trial protocol as part of their work up for consideration by the MDT. Following evaluation, the MDT will consider how they would normally treat each patient according to their standard local practice. Patients eligible for randomisation will be those for whom clinical uncertainty exists regarding whether or not surgery would be of benefit.
This feasibility study aims to determine whether it will be possible to recruit sufficient patients to conduct a large phase III randomised trial. Central ethics and R&D approval have been gained and local site setup is underway.