[Surgical management for pulmonary metastasis]

To investigate the indications of resection for lung metastasis, the surgical procedure and factors affecting the survival based on our experience accumulated for 37 years.

A total of 108 patients with pulmonary metastasis was treated by surgery. Pathology showed 93 carcinoma (86.1%) and 15 (13.9%) sarcoma. Totally 122 operations were performed: partial lung resection 51, segmental lobectomy 7, lobectomy 40, pneumonectomy 15.

After surgery, the cumulative 1-, 3-, 5-, 7- and 10-year post-thoracotomy survivals were 87.9%, 47.3%, 31.7%, 23.7% and 13.9%, with an overall median survival of 34.8 months. Solitary lesions, disease-free interval (DFI) > 36 months, absence of extrathoracic disease and "open" thoracotomy were predictors of a longer survival whereas age, gender, symptom and pathology of the primary tumor were found statistically insignificant prognostic factors.

Surgery should be undertaken for patients who do fulfill these criteria, and "open" thoracotomy is a better choice. Surgical treatment for patients with short DFI and multiple lesions should be attempted with prudence.