Outcomes of Thoracic Surgical Oncology Group 103: Multimodality management in risk-stratified patients with lung-limited metastatic colorectal cancer.

Authors

• Mara B Antonoff
• Zamaan Hooda
• Xiaowen Sun
• May Celestino
• Nathaniel Evans
• Tyler Grenda
• Jack Lee
• Reza Mehran
• Olugbenga T Okusanya
• Ravi Rajaram
• Thomas Waddell
• Garrett Walsh
• Jonathan Yeung
• Ara Vaporciyan
• Kyle G Mitchell
• Van K Morris

Publication/Presentation Date

4-1-2026

Abstract

OBJECTIVE: Thoracic Surgery Oncology Group 103 was a prospective multi-institutional trial that aimed to (1) evaluate the role of perioperative chemotherapy for low-risk patients with metastatic colorectal cancer undergoing pulmonary metastasectomy and (2) characterize the impact of surgery on outcomes for high-risk patients with metastatic colorectal cancer receiving chemotherapy.

METHODS: From July 2018 to September 2023, patients with histologically confirmed primary colorectal cancer and lung metastases amenable to complete margin-negative resection from 3 institutions were enrolled and stratified by low- and high-risk clinical features and randomized accordingly within 2 treatment paradigms.

RESULTS: A total of 22 and 26 patients were enrolled in the low- and high-risk cohorts, respectively. Randomization within the low-risk cohort resulted in 8 individuals (40.0%) receiving perioperative chemotherapy and surgery (+Chemo) and 12 patients (60.0%) undergoing surgery alone (-Chemo). Median overall survival was unable to be calculated for either group, and median recurrence-free survival was 21.8 months for +Chemo and not yet reached for -Chemo (

CONCLUSIONS: Patient accrual targets were not reached, leaving this study underpowered; as such, all analyses are descriptive and hypothesis generating. We were unable to determine differences in survival in the high-risk cohort; however, our findings suggest that adequately selected low-risk individuals can be treated with up-front pulmonary metastasectomy without additional lung-directed chemotherapy.

Volume

30

First Page

101702

Last Page

101702

ISSN

2666-2736

Published In/Presented At

Antonoff, M. B., Hooda, Z., Sun, X., Celestino, M., Evans, N., Grenda, T., Lee, J., Mehran, R., Okusanya, O. T., Rajaram, R., Waddell, T., Walsh, G., Yeung, J., Vaporciyan, A., Mitchell, K. G., & Morris, V. K. (2026). Outcomes of Thoracic Surgical Oncology Group 103: Multimodality management in risk-stratified patients with lung-limited metastatic colorectal cancer. JTCVS open, 30, 101702. https://doi.org/10.1016/j.xjon.2026.101702

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

42079931

Document Type

Article