Pulmonary Metastasectomy in Colorectal Cancer: Health Utilityscores by EQ-5D-3L in a randomised controlled trial show no benefit from lung metastasectomy

Colorectal Cancer

Colorectal Dis. 2020 Oct 1. doi: 10.1111/codi.15386. Online ahead of print.


AIMS: To assess the Health Utility of lung metastasectomy in the treatment of patients with colorectal cancer using the EQ-5D-3L questionnaire.

METHODS: Multidisciplinary colorectal cancer teams at 14 sites recruited patients to a 2-arm randomised controlled trial-Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC). Remote randomisation was used, stratified by site and with minimisation for seven known confounders. Participants completed the EQ-5D-3L questionnaire together with other patient reported outcome measures at randomisation and then again at 3, 6, 12 and 24 months. These were returned by post to the co-ordinating centre.

RESULTS: Between December 2010 and December 2016, 93 participants were randomised 91 of whom returned questionnaires. Survival and patient reported Quality of Life has been published previously, revealing no significant differences between the trial arms. Described here are patient reported data from the five dimensions of the EQ-5D-3L and the visual analogue scale (VAS) Health State. No significant difference was seen at any time point. The estimated difference between control and metastasectomy patients was -0.23(95%CI-0.113,0.066) for the composite 0 to 1 index scale based on the descriptive system and 0.123(95%CI-7.24,7.49) for the 0 to 100 VAS scale.

CONCLUSIONS: Following lung metastasectomy for colorectal cancer, no benefit was demonstrated for Health Utility, which alongside a lack of a survival or QoL benefit, calls into question the widespread use of the procedure.