Workup, Indications, and Guiding Principles of Selection for Pulmonary Metastasectomy

Pulmonary metastasectomy is a potentially curative intervention for many different and distinct primary malignancies. It is safe in a diverse patient population. A short disease-free interval, multiple metastases, large metastases, and incomplete resection are all poor prognostic indicators for survival. Patients should be approached as any lung resection patient would, including a full history and physical, and a thorough review of their imaging, labs, medications, previous surgeries, and pulmonary function tests. All patients should be discussed at a multidisciplinary tumor board, and a formal and united plan with input from all specialties should be developed before offering surgical intervention.