[Surgical treatment of pulmonary metastases. Apropos of 26 cases].

Twenty-six patients with known primary tumors were treated surgically for pulmonary metastases between 1951 and 1979. The metastases were diagnosed more often (58% of cases) by routine radiological examinations than because of thoracic symptoms. While diagnosis of the primary tumor and the metastases was simultaneous in three cases, the average lapse of time between the two diagnoses was 5 years and 1 month in the other cases. In four cases, it was 10 years or more. Lung X-rays showed single tumors more often than multiple tumors (12%). Broncho-fibroscopy was usually normal, but a preoperative biopsy showed the metastatic nature of the tumor in 5 cases. Ablation was by lobectomy (42%), pneumonectomy (23%) or atypical resection (27%). The hospital mortality rate was 7.6%. The survival rate at 1, 3 and 5 years (71%, 39%, and 17%) is identical to that of primitive bronchial tumors, and seems to be influenced by certain factors, such as the locus of the primitive tumor (with a particularly bad prognosis for ENT tumors), the lapse of time between the diagnoses of the primary and secondary tumors, the fact that there is one, rather than several, metastases, or that the metastases are monolateral rather than bilateral, and, finally, the limited nature of the exeresis. These factors prompt regular, systematic and prolonged radiological monitoring in search of further pulmonary metastases.