对于来自结直肠癌（CRC）的孤立肺转移（LM），是否进行激进切除术存在争议。与华权D的肝脏转移标准类似，我们的研究旨在为LM患者分配临床预后评分，以实现更好的手术选择。我们回顾性分析了2002年12月至2022年1月接受LM根治手术的260例CRC患者的数据，验证了不同临床病理特征对总体生存（OS）的影响。单因素分析显示：较高的基线CEA水平（p = 0.0001）、无病生存时间小于等于12个月（p = 0.0043）、LM大小大于2 cm（p = 0.0187）、可切除性结节多个（p = 0.0083）和原发肿瘤淋巴结阳性状态（p = 0.0011）与预后较差相关。在Cox回归模型中，这些特征保持了其独立的OS作用（p < 0.0001），并被选择为临床风险评分的每一项标准。得分为0的患者的5年生存率为88％，而得分为5的患者在2年内无生存。根据0-1分vs. 2-5分范围，我们在中位OS上获得了显著差异：分别为未达到vs. 40.8个月（95 ％CI 36至87.5）（p < 0.0001），将患者分为良好和不良预后。评分的预后作用在中位RFS方面也得到证实：得分为0-1的患者未达到，而得分为2-5的患者为30.5个月（95 ％CI 19.4至42）（p = 0.0006）。当来自CRC的LM可切除时，Meta-Lung评分提供了有价值的预后信息。的确，对于评分为0至1的患者，应考虑进行直接手术；而对于评分为2至5的患者，应谨慎建议手术，并应在前瞻性随机临床试验中比较预防性手术与其他治疗方法的预后。Copyright © 2023 Elsevier B.V. All rights reserved.

Radical resection of isolated lung metastases (LM) from colorectal cancer (CRC) is debated. Like Fong's criteria in liver metastases, our study was meant to assign a clinical prognostic score in patients with LM from CRC, aiming for better surgery selection.We retrospectively analyzed data from 260 CRC patients who underwent curative LM resection from December 2002 to January 2022, verifying the impact of different clinicopathological features on the overall survival (OS).At the univariate analysis: higher baseline CEA levels (p = 0.0001), disease-free survival less than or equal to 12 months (m) (p = 0.0043), LM size larger than 2 cm (p = 0.0187), multiple resectable nodules (p = 0.0083), and positive nodal status of the primary tumor (p = 0.0011) were associated with worse prognosis. In a Cox regression model, these characteristics retained their independent role for OS (p < 0.0001) and were chosen as criteria to be assigned one point each for clinical risk score. The 5-year survival rate in patients with 0 points was 88%, while no patients with a 5-point score survived at 2 years. Based on the 0-1 vs. 2-5 score range, we obtained a significant difference in median OS: not reached vs. 40.8 months (95 %CI 36 to 87.5), respectively (p < 0.0001) stratifying patients into good and poor prognosis. The prognostic role of the score was also confirmed in terms of median RFS: not reached in 0-1 scored patients vs. 30.5 months (95 %CI 19.4 to 42) in patients with 2-5 scores (p = 0.0006).When LM from CRC is resectable, the Meta-Lung Score provides valuable prognostic information. Indeed, while upfront surgery should be considered in patients with scores of 0 to 1, it should be cautiously suggested in patients with scores of 2 to 5, for whom a prognosis comparison between preventive surgery and other treatments should be investigated in prospective randomized clinical trials.Copyright © 2023 Elsevier B.V. All rights reserved.