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Colorectal cancer is the third most frequently occurring malignancy across the globe, with over 1.8 million new diagnoses in 2018 alone. Approximately one-fifth of patients have evidence of metastasis at the time of initial diagnosis and five-year survival for untreated stage IV colorectal cancer is reported to be as low as 10% (1). A number of studies have shown that patients with isolated metastases receiving radical treatment can have 5-year survival rates of up to 50% (2). The term “metastatic colorectal cancer” covers a diverse spectrum of pathology, with treatment strategies varying greatly, dependent upon the extent and site of metastasis. Common sites of spread include liver, lung, bone, brain and peritoneum, with the lungs the second most common location after the liver. Metastases are termed to be either ‘synchronous’ or ‘metachronous’, dependent upon whether they are identified during the initial diagnostic work-up of the primary colorectal tumour (synchronous) or at any point afterwards(metachronous). ‘Initial’ (as opposed to ‘non-initial’) is a term used to delineate the sequence of metastatic spread. The term ‘initial lung metastasis’ refers to a specific situation where the lungs are the first site of metastasis. An additional classification addresses whether the lung metastasis is ‘isolated’ (not accompanied by additional extrapulmonary metastasis) or ‘non-isolated’. Presence or absence of either the original primary tumour or a local recurrence of this primary tumour does not affect the classification of lung metastases as either isolated or non-isolated (3).

A review of interventional treatments for colorectal lung metastases: is it time for a change in practice?