Surgical therapy of pulmonary metastases - 10-year results

The surgical therapy of selected secondary pulmonary tumors, including both solitary and multiple or bilateral tumours, is currently a generally accepted therapeutic procedure demonstrably extending the long term survival of these patients.

The purpose of the present study is a ten-year retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors.

In 2000-2009, 87 patients (of which 44 were male with a median age of 64 years) with secondary pulmonary tumors underwent surgery at the departments of the authors of this study. Solitary metastases were found in 60 patients, multiple metastases in the remaining patients, while 13 patients had bilateral metastases. The median disease-free period from surgery of the primary tumor was 31 months.

In total, 74 unilateral and 13 bilateral surgeries were performed in one or two periods. The most common type of surgery included anatomical pulmonary resections (32 procedures), wedge resections (29 procedures) and laser excisions (24 procedures). In total, the radical resection was performed in 156 metastases. Post-operative morbidity was 17.2 % with zero mortality. A proportion of 50.6 % of operated patients survived after resection of metastases with median survival of 39 months. The overall three-year and five-year survivals in the group were 57 % and 38 %, respectively. A proportion of 35.6 % of patients live after resection of metastases without disease progression, and the median is 15 months.

The achieved results confirm the positive role of pulmonary metastasectomy in the therapy of disseminated cancer disease (Tab. 1, Fig. 5, Ref. 34).