Late results of surgical treatment of pulmonary metastases.

Surgical removal of one or several metastases with a potentially curative aim is possible in the case of isolated pulmonary metastases. The surgery is always part of an overall oncological concept. Between 1972 and 1984, surgery was indicated in 295 cases in 261 patients and 304 thoracotomies were performed. The procedure was classified as potentially curative in 76% of the cases. The 5-year survival probability in this patient group amounted to 38% for all organic tumors. The definitely best prognosis with 5-year survival rates of 42% is observed for caval metastatic carcinoma. Due to the excellent chemotherapeutical regimens, testicular teratomas reach the best individual result with a 3-year survival probability of 71%. Decisive for the long-term prognosis is the removal of all visible and palpable metastases. If radical resectability is possible, the number of metastases is only of secondary importance. Besides radicality, metastatic route and type of the primary tumor, duration of the disease-free interval and the size of the metastases are also of prognostic significance. Predominating resection procedures are the atypical and segment resection and the enucleation which yield the best survival rates.