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Eur J Cardiothorac Surg 2006;30:217-222
© 2006 Elsevier Science NL

Pulmonary metastases from epithelial tumours: late results of surgical treatment

^a Thoracic Surgery Department, University "A. Avogadro", Novara, Italy
^b Thoracic Surgery Department, University of Torino, Torino, Italy

Received 1 January 2006; received in revised form 15 April 2006; accepted 22 April 2006.

^_* Corresponding author. Tel.: +39 0321 3733076; fax: +39 0321 3733578. (Email: ottaviorena{at}libero.it).

Objective: Development of distant metastases is one of the primary characteristics of malignant tumours. During the last decades, lung metastasectomy has been progressively accepted as a therapeutic option in oncology patients. The present paper aims to evaluate the long-term results and factors influencing prognosis in patients submitted to lung resection for metastases from extrapulmonary epithelial tumours. Methods: We retrospectively analysed data of 202 patients undergoing 207 procedures of lung metastasectomy between January 1980 and December 2003. Factors that may influence long-term prognosis such as completeness of resection, histology of the tumour, disease-free interval, number of resected lesions, involvement of hilar or mediastinal lymph nodes, systemic treatments were investigated. Results: Complete resection was carried out in 169 patients (83.7%). The more frequent lung resection was sublobar in 67.6% of cases, but rarely in selected patients bilobectomy or pneumonectomy has been carried out too. Perioperative morbidity and mortality were 7.7% and 0.9%. Mean disease-free interval was 49 ± 48 months. Mean follow-up was 33 ± 31 months, 5-year and 10-year survival rates for completely resected patients were 43% and 17%, respectively. By univariate and multivariate analyses, completeness of resection, disease-free interval of 36 months or more, and single resected metastasis were found to be significant prognostic factors. Conclusions : Resection of epithelial lung metastases allows an acceptable prognostic result in appropriately selected patients with very low perioperative morbidity and mortality. Factors such as high disease-free interval, single metastasis and completeness of resection are demonstrated and confirmed to be significantly associated with long-term survival.

Key Words: Epithelial tumours • Lung metastases • Surgery • Prognosis