Results of combined chemosurgical therapy for pulmonary metastases.

The authors study the results of the combined surgery and postoperative chemotherapy, for treatment of pulmonary metastases. At Léon-Bérard Center, 50 patients have been operated on since 1963. The sites and histologies of the primitive cancers are varied, corresponding to 12 epidermoid cancers, 12 adenocarcinomas, 10 osteogenic sarcomas, 1 Ewing's tumor, 3 malignant melanomas, 6 testicular tumors, and 4 others. The total survival rate is 30% in 4 years. The prognosis is influenced by different factors, which are studied. It depends on the histology of the primitive cancer and the type of the pulmonary excision. It is suggested that postoperative chemotherapy improves the results. It appears that the longer the free interval is between the treatment of the primitive cancer and the discovery of the pulmonary metastasis, the better the prognosis. The correlation between the time lapse of the free interval and the survey after pulmonary excision is studied. The conclusions of the authors are: The association of surgery and chemotherapy improves the results and enforces the indications for surgical excision of pulmonary metastases.