The surgical management of pulmonary metastasis: current concepts

Lung metastases have been found in 25-30% of all patients with cancer at au topsy. Those patients satisfying criteria for surgical resection represent a much smaller subgroup. Given the potentially curative nature of pulmonary metastasectomy in the ab sence of disseminated disease, it has become widely accepted as an importan t treatment option for a variety of malignancies with metastasis to the lun gs. A standardized approach remains unfounded however, given limited number s of patients, various histologic subtypes and few published studies utiliz ing randomized prospective methodology. Ultimately, the development of metastasis represents a major determinant of survival for patients with cancer. Pulmonary metastasectomy is an importan t treatment modality for patients with metastatic pulmonary disease. The in dications for pulmonary metastasectomy and the surgeon's role in pulmonary metastatic disease continue to evolve. Future prospective studies and the c ompilation of comparable data yielding prognostic factors for specific hist ologies will better define indications for resection. (C) 2001 Elsevier Sci ence Ltd. All rights reserved.