OBJECTIVES : Due to the lack of data on the burden of pulmonary metastasis, the study aimed to quantify the epidemiologic burden in France (with extrapolation to other European countries) including prevalence, number, location, size, and resectability of the metastases, patient operability, and origin of the primary tumor.

METHODS : The French Cancerology database, a cross-sectional survey based on medical chart review across a representative sample of oncology practitioners (2017), provided prevalence data. This was complemented by a custom primary research targeting the same specialist mix found to provide lung metastasis information in Cancerology. 19 oncologists, 8 thoracic surgeons, 6 gastroenterologists, and 6 pulmonologists defined details on metastases number, size, location, resectability and patient operability. Results were extrapolated to EU-4 to create estimates, as the prevalence of lung cancer showed homogeneity across EU-5.

RESULTS : Pulmonary metastasis had a prevalence of 30,209 patients in France. 53% of patients had less than 4 metastases. Of these, 47.4% had one metastasis, 30.3% had two, and 22.3% had three. Colorectal cancer was the primary tumor in 46% of cases, followed by kidney cancer (12%) and breast cancer (11%). For patients with 1-3 metastasis, 19% and 10% of the metastases were in the middle and central lung, respectively, and 65% are ≤3 cm for both locations. 75% of the metastases were potentially resectable, 17% were non-resectable due to location or vascularity, and 8% were potentially resectable but considered inoperable. Extrapolation to EU4 countries was performed using these proportions.

CONCLUSIONS : The patient population not receiving treatment today is considerable. A relevant number of metastases were considered potentially resectable but considered inoperable. Without the recourse of surgery, timely and effective management poses a high unmet need in these patients. Any minimally invasive, safe intervention that can access and resect these metastases will offer significant benefits to these patients.