Lung cancer metastases--management

Distant metastases from lung cancer is a common occurrence in a common malignancy. Almost every organ may be involved but the extra-thoracic sites posing common clinical problems are brain metastases, cord compression, painful bone metastases or pathological fractures, nodal spread and liver involvement. A review of the records of 225 lung cancer patients referred to the Therapeutic Radiology Department, Singapore General Hospital, during the calender year 1985 showed a metastatic rate of 13.8% at referral. On subsequent follow up, an additional 49 patients (21.7%) developed metastases clinically. The organs involved were bone (21 patients), spinal cord (21 patients), brain (18 patients), liver (13 patients), other lung (7 patients) and other sites (17 patients). The management of metastases to the brain, bone and liver, and spinal cord compression will be discussed.