PULMONARY METASTASECTOMY

Between 1988 and 1994, 24 patients underwent 32 procedures for pulmona ry metastases. Primary tumours were gastrointestinal, malignant melano ma, osteogenic sarcoma, renal cell carcinoma, head and neck cancer and finally testicular carcinoma. Age ranged from 16 to 78 years, with a female/male ratio of 7/17. Pulmonary metastasectomy was performed in 9 cases through median sternotomy, in 21 cases through thoracotomy and in 2 cases by thoracoscopy. In 9 cases repeated resection was necessar y. Overall mortality was 0% (95% confidence limits are 0.00 +/- 14.25) . Computed tomography of the chest in combination with tumour markers, were most important during follow-up to detect recurrent disease. The overall 5-year actuarial survival and disease-free survival were 0.56 +/- 0.17 and 0.30 +/- 0.14 respectively. With regard to testicular ca rcinoma 5-year actuarial survival was 100%. Pulmonary metastasectomy i s a recommended procedure in the treatment of selected patients with m etastatic pulmonary disease. Resections should be as conservative as p ossible and if necessary, repeated. In our study this procedure proved especially effective in case of testicular carcinoma.