[Surgical treatment of pulmonary metastases]

Between 1977 and 1986, 23 patients with pulmonary metastases were operated upon in a thoracic and cardiovascular surgery department, totalling 26 thoracotomies. The time elapsed between treatment of the primary tumour and that of the metastasis (single or multiple) ranged from 11 to 89 months. The metastases were discovered on follow-up x-ray films of the chest in 15 cases. All patients underwent preoperative lung function assessment, pulmonary radiotomography or thoracic computerized tomography and bronchial fibroscopy. Surgery consisted of tumorectomy (12 cases), lobectomy (5 cases), pneumonectomy (3 cases), segmentectomy (1 case) and tumorectomy combined with lobectomy (1 case). In 2 patients only exploratory thoracotomy could be performed. The operative mortality was nil. The mean survival counted from the date of the last thoracotomy was 17 months (range 1 to 51 months). The mean absolute survival was 24 months (range 13 to 51 months). The actuarial survival rate was 60 percent at 1 year, 47 percent at 2 years and 26 percent at 3 years. Terminal respiratory failure was the main cause of death. Surgery within a multidisclinary approach of lung cancer must therefore spare as much lunch parenchyma as possible to preserve the patient's future.