[Surgical therapy of lung metastases]

The operative treatment of lung metastases is a procedure which is performed world-wide in a carefully selected group of patients. Operative treatment can be performed on the assumption that the treatment of the primary tumor has been successfully completed, that there are no extrapulmonary metastases, and that the patient will be operable under local and general aspects. The success of the operation depends on the complete resection of all visible and palpable metastases. As approach we choose total median sternum splitting or lateral thoracotomy. The most common surgical technique is the atypical resection of the metastases, i.e. the transsegmentectomy. The mortality rate was found between 0.0 and 2.0 (-5.0)%. The aim of the operation is the individual prolongation of life with a good quality. However, some patients can be cured definitively. The 5-year-survival-rate was found between 30 and 45%. Significant prognostic factors are the resectability as well as the tumor-free interval. Of minor importance are the type and class of the primary tumor, a union bilateral metastatic spread, and an involvement of lymph nodes.