Background. Disease-free interval, histology of primary tumor, and num
ber and size of metastases resected (at first metastasectomy) were stu
died after resection of pulmonary metastases. Methods. Between 1980 an
d 1993, 276 consecutive patients underwent lung resections for curativ
e removal of metastatic disease. At subsequent relapse, 63 patients ha
d a second-stage metastasectomy, 12 went on to a third phase, and 2 pa
tients had four stages. Results. The primary tumor was sarcoma in 126
cases (46%), teratoma in 88 (32%), carcinoma in 53 (19%), melanoma in
5, and miscellaneous in 4. Actuarial survival was 69% at 2 years (95%
confidence interval 62% to 74%), 48% at 5 years (40% to 55%), and 35%
at 10 years (23% to 44%). Conclusions. Survival was not related to dis
ease-free interval. Multivariate analysis showed that nearly all predi
ctive information can be obtained through histologic studies (p < 0.00
01); inclusion of the number of metastases resected contributed to a l
esser degree (p = 0.032). Short disease-free intervals, numerous lung
metastases, or even deposits recurring after a first or second metasta
sectomy should not preclude patients from operation. (C) 1997 by The S
ociety of Thoracic Surgeons.