Pulmonary Metastasectomy: A Moving Target

Abstract

For at least 60 years, surgical resection has been a widely used approach to the management of patients with lung metastases from a variety of solid tumors. For many of these patients, surgical resection has provided the only potentially curative treatment. Analyses of numerous retrospective series have led to well-accepted surgical selection criteria: a primary tumor that has been definitively controlled, metastases limited to the lung that can be completely resected, ability of the patient to tolerate the planned operation, and lack of a better alternative treatment. The number of lung metastases, the disease-free interval since treatment of the primary tumor, the tumor doubling time, the presence of lymph node metastases, the histology of the primary tumor, and in some instances, elevated serum markers such as carcinoembryonic antigen are known to influence outcome and may be incorporated into the decision of whether to offer surgery to the patient. However, there remain many controversial aspects to