ABSTRACT

Purpose:

To evaluate the importance of surgery for isolated lung metastases originating from different tissues and therapy for primary tumor control.

Methods:

Twenty-one patients who underwent surgery for pulmonary metastases from July 2002 to January 2005 were reviewed retrospectively. Patients were classified in terms of age, gender, primary tumor, disease-free interval, location and number of metastases. Type of surgery, the number of excised metastatic lesions and postoperative additional therapy were investigated. The relation between postoperative therapy and survival was evaluated.

Results:

The origins of the metastasis were the breast (4), kidney (4), bone (3), female genital system (3), thyroid (2), liver (1), colon (1), soft tissue (1), Wilms tumor (1), and thymus (1). Disease-free interval (DFI, the time between the diagnosis of primary pathology and the first detected lung metastasis) is 25.2 months (1-120 months). DFI in patients (n=4) with recurrent lung metastasis after metastasectomy is 5.75 months. Two patients had contralateral lung recurrences, after 12 and 4 months, and a third patient had extrapulmonary lymph node metastasis. The last patient had bilateral recurrence (this patient had bilateral metastasis initially). Two of the recurrent patients had chemotherapy but the other two patients could not undergo extra therapy because of renal failure and toxic hepatitis. None of the patients had major morbidity or mortality postoperatively. Seven patients died because of various reasons other than malignancy.

Conclusion:

Surgical therapy is a major indicator in the prognosis of metastatic lung tumors. To allow feasible metastasis surgery, the primary tumor should be under control and adequate postoperative medical treatment must be planned.