Pulmonary metastasectomy: the discussion continues.

The authors of the PulMiCC trial (PT) have been very passionate and dedicated to the topic of pulmonary metastasectomy. The fact that so many papers were published prior to and after the results of the PT itself demonstrates how much work and effort they have put into this topic. Overall, the PT results were published in 3 steps: first, a paper including 65 randomized patients [1]; second, a publication including 93 randomized patients [2]; and third, an observational publication including 512 mostly nonrandomized patients [3]. In their actual review, the PulMiCC authors (PA) are evaluating the response to their trial and criticize that 40 of 65 studies refer only to their first ‘preliminary’ publication that included 65 patients [4]. The question arises why the PA first published data on 65 patients, then 18 months later published data on 93 patients, and finally published another study including nonrandomized patients. It is obvious that this would have led to confusion and raise questions.