Surgical management of pulmonary metastases

Pulmonary metastases is a devastating complication for the cancer patient and its occurrence signals a lethal outcome. Recently, surgery is being offered more frequently to certain patients with pulmonary metastases. In this paper, the criteria used to select these patients are reviewed. Also, the various prognostic factors, including tumor histology, number and location of metastases, disease-free interval, tumor-doubling time are presented and their effect on survival is evaluated. Even with the development of objective criteria for the selection of patients for surgery, no single criterion should be used to exclude patients from surgery, especially when no alternative therapy is available.