Surgical Resection of Lung Metastases

The aim of this study was to report our experience and outcomes in patients previously diagnosed with primary malignant solid tumors who subsequently underwent surgical resection of lung nodules whose final result on the pathological exam was a metastasis.

Between January of 2008 and September of 2016, seventy-one patients underwent pulmonary resection by video-assisted thoracic surgery (VATS) or by thoracotomy, for lung metastasis. Data were collected regarding demographics, tumor features, treatment and outcome.

The patients included in this retrospective study (n=71) underwent a total of 79 surgeries. The study sample included 44 (62%) male and 27 (38%) female with a mean age of 60.8 years (range, 20-82 years). The primary tumor site was colorectal in 46 patients, lung in 6, soft tissue in 4, kidney in 3 and others tumors in 12. Sixty-four surgeries (81%) were performed due to a solitary metastasis. Ten (13%) surgeries were performed by VATS and 69 (87%) were performed by thoracotomy. We performed 50 (63%) wedge excisions, 20 (26%) lobectomies, 8 (10%) anatomical segmentectomies and 1 (1%) right pneumonectomy. Median hospital stay was 5 days (range, 2-21 days). Postoperative complication rate was 7.6%. Postoperative mortality was 1.3%. Median follow-up was 32 months (range 0 to 86 months). Overall 3 and 5 year survival regardless of the primary tumor site was 70% and 45%, respectively. Overall 3 and 5 year survival for the colorectal carcinoma was 73% and 42%, respectively.

These results support that lung metastasectomy is a safe and effective procedure for patients with treated primary tumors. A select group of patients can achieve long-term survival after resection.