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Principal Investigator - Prof Dame Lesley Fallowfield

Data Manager - Shirley May

Funder: Cancer Research UK

PulMiCC

The increasing use of CT scans in routine follow up of colorectal cancer patients has led to earlier diagnosis of cancer deposits in the lungs (pulmonary metastases). These deposits can be removed by surgery (pulmonary metastasectomy) but this procedure carries risks as well as potential benefits. According to the location of the lung deposits, it may be necessary to remove a significant amount of normal lung tissue during the operation. Following surgery, some patients may be left with reduced lung function, which could affect their ability to conduct normal daily activities and negatively affect their quality of life (QoL).

A recent survey showed that surgeos' opinions vary widely in the types of patients they consider for pulmonary metastasectomy due to a lack of evidence regarding which types of patients benefit from it. The PulMiCC trial aimed to investigate the risks and benefits of pulmonary metastasectomy to provide reliable evidence to guide surgeons in the future.

PulMiCC was a two stage randomised controlled trial.

Stage - registration

Eligible patients gave consent for tests and evaluation according to the protocol and local practice guidelines. Following evaluation by the local multi-disciplinary team, patients for whom uncertainty existed whether surgery would be of benefit were eligible for stage 2.

Stage 2 randomisation

Eligible patients were randomised equally between:

• Arm 1, active monitoring according to local practice guidelines (control)
• Arm 2, active monitoring according to local practice guidelines with pulmonary metastasectomy

Quality of life data were collected directly from patients using three questionnaires (FACT An - L, EQ-5D-3L, 6 item short form STAI). It is hoped that analysis of the QoL and clinical data collected in the trial will provide robust evidence on the risks and benefits of pulmonary metastasectomy to guide surgeons and patients in the future.

• Current Stage:

  Archived

• Publication

  The fallacy of large survival gains from lung metastasectomy in colorectal cancer https://doi.org/10.1016/S0140-6736(20)32760-4

• Publication

  Pulmonary metastasectomy in colorectal cancer: Time for a trial https://doi.org/10.1016/j.ejso.2008.12.005

• Publication

  Rapid Response: Re: Colorectal cancer: summary of NICE guidance https://www.bmj.com/content/368/bmj.m461/rr-2

• Publication

  The Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) burden of care study: Analysis of local treatments for lung metastases and systemic chemotherapy in 220 patients in the PulMiCC cohort https://doi.org/10.1111/codi.15833

• Publication

  Current concepts: pulmonary metastasectomy for colorectal cancer

• Publication

  Randomized Controlled Trial of Pulmonary Metastasectomy in Colorectal Cancer: PulMiCC International Is Open in Italy https://doi.org/10.1634/theoncologist.2012-0476

• Publication

  Reply to 'Comment on "The myth of pulmonary metastasectomy"' https://www.nature.com/articles/s41416-020-01062-6.

• Publication

  The Pulmonary Metastasectomy in Colorectal Cancer cohort study: Analysis of case selection, risk factors and survival in a prospective observational study of 512 patients https://doi.org/10.1111/codi.15651

• Publication

  Pulmonary Metastasectomy in Colorectal Cancer: The PulMiCC Trial https://doi.org/10.1097/JTO.0b013e3181dca239

• Publication

  Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC): a phase III, multi-centre clinical trial https://doi.org/10.1186/s13063-019-3837-y

• Publication

  The Prospective Observational Cohort and the Nested Randomized Controlled Trial in the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC Study) Question the Reliance on Existing Evidence for the Magnitude of Benefit From Lung Metastasectomy https://doi.org/10.1097/COC.0000000000000847

• Publication

  Pulmonary metastasectomy in colorectal cancer: the PulMiCC trial http://dx.doi.org/10.1136/thoraxjnl-2011-200015

• Publication

  Pulmonary Metastasectomy in Colorectal Cancer: Health Utility scores by EQ-3D-3L in a randomised controlled trial show no benefit from lung metastasectomy https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.15833

• Poster

  Patients' views on the PulMiCC trial information: Results from a survey posters/Accept decline CTM conference May 2017 final.pdf

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