Pulmonary metastasectomy in Iceland: Long-term nationwide trends and outcomes.

Authors

Carlos Magnus Rabelo, Luis Gisli Rabelo, Sigurdis Haraldsdottir, Tomas Gudbjartsson, Halla Vidarsdottir

Published in

Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. Pages 14574969261468491. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

Pulmonary metastases are generally associated with poor prognosis, and only a selected subset of patients undergo surgery. However, population-level data on outcomes remain limited. This study aimed to evaluate temporal trends and outcomes of pulmonary metastasectomy (PM) in a nationwide cohort over more than two decades.
This retrospective cohort study included all patients who underwent PMs in Iceland between 2001 and 2021. The study period was divided into three 7-year intervals for comparison. Survival was evaluated from the first PM using the Kaplan-Meier analysis, and prognostic factors were assessed using multivariable Cox regression.
A total of 179 PMs were performed, with procedure volume increasing significantly during the final study period. The median age at the first PM was 62 years, and 54% of patients were male. The most common indication was metastatic colorectal carcinoma (39.3%), followed by renal cell carcinoma (16.4%) and sarcoma (10%). Median follow-up was 52 months. Early major postoperative complications occurred in 2.2% of cases, with a 30-day mortality rate of 1.1%. Five-year overall survival was 49.7%, and 55.5%, 60.9%, and 35.7% for colorectal carcinoma, renal cell carcinoma, and sarcoma tumor subtypes, respectively. Five-year overall survival increased significantly from 31% to 55% across the first and last 7-year periods. In addition to sarcoma histology and an operation in the first period, negative prognostic factors included advanced age, a greater number of metastases, and a prior extrathoracic metastasectomy.
The use of PM increased over time and was accompanied by improved long-term survival, likely reflecting advances in systemic therapy, imaging, and patient selection. The procedure had a low rate of major complications, and 5-year survival rates were comparable to those reported in international data.

PMID:
42552285
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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