A ten-year experience with surgical resection for patients with metastatic lung tumors.

Removal of metastatic lung tumor was performed for 27 patients in a period from January, 1972 to December, 1981. They included 22 carcinomas and 5 sarcomas. Diagnosis as having lung metastasis was made after removal of the primary tumor in 18 patients and at the time of the first detection of the primary tumor in 4 patients. In 5 patients the operation for the metastatic tumor preceded that for the primary malignancy. Metastatic tumors were localized in one lobe in 13 patients. Thirteen of the 27 patients underwent lobectomy and 14 received other types of operation, with or without hilar and/or mediastinal lymphnode dissection. Four patients underwent bilateral thoracotomy. Survival rates at 3 and 5 postoperative years of the group of patients who underwent the operation for primary malignancy first were both 49 percent. The number of lesions removed or the type of operation did not seem to have correlations with the survival rate. Patients whose tumor-free interval was more than 40 months tended to survive longer than those who had an interval less than 40 months. The group with a tumor doubling time of more than 50 days showed a higher survival rate than the group with a doubling time of less than 50 days. Of the 4 patients thoracotomized bilaterally 2 are alive for 20 and 34 months postoperatively, while the other 2 died at 20 and 65 months after the operation. In the selected patients with metastatic lung tumors, surgical treatment can be conducted with a reasonably good result, even though the metastatic malignancy is multiple or bilateral.