PulMiCC Summary for Healthcare Professionals

Patients who have been treated successfully for bowel cancer (colorectal cancer) sometimes go on to develop nodules of disease in another part of the body.  If this disease is found to be related to the original cancer it is called a metastasis.  Some patients develop one or more metastases particularly in the lungs or the liver.

There is a growing trend to remove lung metastases with an operation, in the belief that this will help patients live longer, however there have not been any scientific studies to prove this.  There is also very little published information about the side effects of this surgery and how it affects subsequent daily living.

This is a randomised study to determine whether it will be possible to conduct a large randomised controlled trial investigating the value of pulmonary metastasectomy (surgery to remove lung metastases) in patients who have been successfully treated for colorectal cancer.

There is a two stage consent and randomisation process.  Firstly, patients will be invited to consent to having a full range of investigations to assess their suitability for surgery.  If found to be suitable, they will then be invited to consent to randomisation between active monitoring of their disease or active monitoring with pulmonary metastasectomy.  Patients will be followed up regularly for 5 years to assess their disease status and to measure their quality of life and lung function.

SHORE-C which runs the Quality of Life part of the PulMiCC study provides further information in its training DVD for healthcare professional.

Further reference: 

UK Clinical Research Network Study Portfolio

PulMiCC Summary for Participants

The PulMiCC study is investigating the benefits and possible harms of metastasectomy in patients with colorectal cancer that has spread to the lung.

Some patients who have been treated for colorectal cancer go on to develop one or more nodules in their lungs, which turn out to be cancer deposits (called metastases).  In patients who are fit enough, current treatment includes removing the nodule(s) by surgery (called metastasectomy).  The patients offered this surgery are usually otherwise well and complications are uncommon but occasionally side effects from lung surgery can be severe.  When some of the lung is removed, breathing can be more difficult, because the remaining amount of lung cannot take in as much air.  We don’t know how big an impact this has on the quality of patients’ lives because, at present, there are no published studies.

Importantly doctors do not have good research evidence to show that patients having this surgery live for any longer than those who do not.   Some small studies have been published which show graphs of survival after metastasectomy but they don’t show any graphs of survival for patients who did not have the operation for comparison.

SHORE-C which runs the Quality of Life part of the PulMiCC study provides further information for potential participants in its PulMiCC patient DVD.

Please note that the PulMiCC study is now managed by the Surgical & Interventional Trials Unit (SITU) formerly CTG at University College London due to the closure of the Clinical Trials and Evaluation Unit (CTEU) at the Royal Brompton Hospital. Any reference to the CTEU should be read as SITU (formerly CTG).
Thus all study documentation and study queries should be addressed with immediate effect to:

Surgical & Interventional Trials Unit (SITU) formerly CTG 
Division of Surgery & Interventional Science
Faculty of Medical Sciences
University College London

Tel:     +44 (0)20 7679 9280
Fax:    +44 (0)20 7679 9290
Email: SITU.PulMiCC@ucl.ac.uk

The management of the Quality of Life (QoL) part of the study remains unaffected and any QoL documentation and queries should be continued to be send to:

Sussex Health Outcomes, Research & Education in Cancer (SHORE-C)
Brighton & Sussex Medical School
University of Sussex
Falmer, Brighton, BN1 9QG

Phone: +44 (0)1273 873019
Fax:     +44 (0)1273 873022

The information below is for participating sites only. If you are a participating site (or are about to be joining the study) and require access, please email SITU.PulMiCC@ucl.ac.uk with your request.
  • Treasure T, Monson K, Fiorentino F, Russell C. Operating to remove recurrent colorectal cancer: have we got it right? BMJ2014;348:g2085
  • Treasure Tom, Brew-Graves Chris, Fallowfield Lesley, Farewell Vern, Golesworthy Tal, Leonard Pauline et al. The need to determine whether lung metastasectomy improves survival in advanced colorectal cancer BMJ 2014; 348:g4085