Chirurgie der lungenmetastasen

In the natural history of cancer many types of extrathoracic tumors metastasize to the lungs. The most significant factor in selecting patients for surgery include control of the primary tumor, absence of extrathoracic metastases, lack of effective system therapy, and sufficient cardiopulmonary reserve for the planned operation. The principle of surgery for lung metastases is the removal of all lesions in the lungs that are either visible or detectable by palpation. This may be combined with complete dissection of all ipsilateral lymph nodes. Pulmonary metastasectomy should be performed by the most limited parenchymal resection permitting a curative resection. The decision to proceed with surgical resection of lung metastases should be a multidisciplinary one, together with the medical oncologist. A selected group of patients with metastases limited to the lungs may benefit from pulmonary metastasectomy with a 5-year survival rate up to 60%.