Results of surgical treatment of lung metastases in children.

Between 1970 and 1979, 14 patients were operated on for pulmonary metastases. In 9 of these the primary tumour was a Wilms' nephroblastoma. Five out of the 14 patients are presently alive and free from disease (3 to 10 years after pulmonary resection). Primary tumours of the survivors were Wilms' tumour in 3 cases, an ovarian teratoma in one patient and a Ewing's sarcoma in one patient. Two of survivors had bilateral involvement and one had multiple metastases of one lung with pleural exudation. The disease-free interval was the same among the survivors and the non-survivors. It is apparent from the present material that some patients with a very poor prognosis as predicted from different prognostic factors can be cured after surgical excision of the metastases. The surgical procedure in children involves a very small risk and only moderate discomfort. An active surgical approach is therefore recommended.