FACTORS INFLUENCING LONG-TERM SURVIVAL AFTER LUNG METASTASECTOMY

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.