[Surgical management for pulmonary metastasis].

Objective: To investigate the indications of resection for lung metastasis, the surgical procedure and factors affecting the survival based on our experience accumulated for 37 years.

Methods: A total of 108 patients with pulmonary metastasis was treated by surgery. Pathology showed 93 carcinoma (86.1%) and 15 (13.9%) sarcoma. Totally 122 operations were performed: partial lung resection 51, segmental lobectomy 7, lobectomy 40, pneumonectomy 15.

Results: After surgery, the cumulative 1-, 3-, 5-, 7- and 10-year post-thoracotomy survivals were 87.9%, 47.3%, 31.7%, 23.7% and 13.9%, with an overall median survival of 34.8 months. Solitary lesions, disease-free interval (DFI) > 36 months, absence of extrathoracic disease and "open" thoracotomy were predictors of a longer survival whereas age, gender, symptom and pathology of the primary tumor were found statistically insignificant prognostic factors.

Conclusion: Surgery should be undertaken for patients who do fulfill these criteria, and "open" thoracotomy is a better choice. Surgical treatment for patients with short DFI and multiple lesions should be attempted with prudence.