A perspective on lung metastasectomy: a review of a flawed concept and the failure to use available evidence resulting in an illusion of benefit

: In this special series devoted to lung metastasectomy, our purpose is provide a thought provoking challenge widespread clinical practice. The forms of evidence recognised as most trustworthy in health care research are randomised controlled trials, meta-analysis trials and expert analysis big databases. These have all been used investigate the effectiveness metastasectomy its commonest application which colorectal cancer they no support for it. Little attention has paid evidence, while according Society Thoracic Surgeons’ consensus, there over thousand uncontrolled reports. They continue appear can be seen issue. To take long view we examined writings British Medical Journal Lancet from 1890 1920 on four topics, commonplace at time: tuberculosis, pleural effusion, rheumatic mitral stenosis bloodletting. We reviewed available present times. Our historical topics were relevant various times evolving practice surgery chest. different ways reasons longer thoracic surgical preoccupations. so weak, magnitude likely benefit marginal, understanding treatment metastasis amenable change, that anticipate will also consigned history.