Extending surgery for pulmonary metastasectomy: what are the limits?

Introduction: The purpose of pulmonary metastasectomy is to remove all known remaining cancer with the purpose of cure or to lengthen survival. Little information is available on the extent of surgery that is justified and or on reasonable evidence based limits to the extent of surgery.

Methods: A systematic review was designed to evaluate the role of extended surgery in the treatment of lung metastasis. For this analysis, the following three research questions were formulated.

Results: Most information concerning extremes of surgery is in the form of case reports, small series, or sporadic cases within a retrospective report of a larger group of patients undergoing pulmonary metastasectomy. Meta-analysis was ruled out because of the insufficient quantity and quality of data in the available literature.

Conclusions: Evidence-based recommendations for extended treatment of lung metastasis are at best weak. We have summarized the available data to provide the most up to date information regarding extended surgery in an attempt to define limits in the treatment of lung metastasis.