[Principles of oncological surgery for lung metastases in paediatric solid tumours]

Distant metastases regularly occur in cases of paediatric solid tumours. Overall the most common localisation of metastases is the lung. The correct treatment of lung metastases represents a prognostic factor in most paediatric solid tumours. Guidelines for the therapy of lung metastases are commonly included in the protocols of the different multicentric treatment trials. However, specific surgical aspects are usually not addressed in these protocols. The aim of this article is to present the principles of surgery for lung metastases in paediatric solid tumours. The principles of surgery for metastases of the most common extracranial paediatric solid tumours are presented including aspects of the diagnostic work-up, surgical preparations, and surgical procedures. Special points of interest are discussed focusing on the different entities. Surgery for lung metastases in paediatric solid tumours can be performed with a good surgical outcome regardless of the patients' age. Large numbers of sequelae can be surgically excised. Depending on the localisation sternotomy is an option concerning the surgical approach. Surgery for lung metastases in paediatric solid tumours is a safe method when respecting the principles for the procedure. It has a positive influence on the patients' prognosis. An aggressive surgical procedure may be justified depending on the tumour entity. An interdisciplinary approach including paediatric oncology and radiology is mandatory in any case.