Secondary pulmonary malignancy

After the liver, the lung is the second most common site for metastatic inv olvement in neoplastic disease. Consequently, 20% to 54% of patients with c ancer have pulmonary metastases at some point in the natural history of the ir disease. In the absence of extrathoracic metastases (similar to 25% of p atients with disseminated disease), complete resection is associated with i ncreased survival, regardless of histology. With appropriate patient select ion, life expectancy often is improved, and, in some cases, cures are repor ted with resection alone or in combination with chemotherapy Even in the co ntext of unresectability, surgical forms of palliation often improve qualit y of life. For other patients (e.g., these with nonseminomatous germ cell t umors), surgery may have a more diagnostic role, such as defining residual disease that is potentially amenable to salvage forms of therapy.