[The role of systemic therapy of lung metastases with lymph node involvement]

Modern systemic therapy with chemotherapy, targeted therapy and immunotherapy has led to a significant improvement in the overall survival in many tumor diseases over the past 15 years. Thus, the surgical treatment of lung metastases and lymph node metastases is not only valuable to achieve a cure for selected tumors but it can and must be used to eliminate tumor growth peaks in the case of a circumscribed progression. These can be an expression of tumor heterogeneity that cannot be achieved by systemic therapy. Depending on the dynamics and extent of the metastasis, the therapeutic approach must be individually decided in the tumor board.