The number of pulmonary metastases: influence on practice and outcome.

From 1940 to the mid-1960s, pulmonary metastasectomy was performed infrequently and only in selected cases. Although the number of nodules was not considered a contraindication to resection, patients with bilateral disease were believed to have a poor prognosis and, thus, were not considered for operation. Later in 1970, metastasectomy was being undertaken with more liberal indications with respect to numbers being removed. It must be borne in mind that the number of metastases is a reflection of the degree of dissemination of the cancer, although in current practice, the presence of multiple metastases is not a contraindication to metastasectomy in either epithelial cancers or sarcomas.