YANG Longhai , LI Junpeng , YE Bo , et al .
  • 1.Department of Thoracic Surgery, Cancer Hospital &;
  • Institute, Chinese Academy of Medical Sciences &;
  • Peking Union Medical University, Beijing 100021;;
  • 2.Depart ment of Thoracic and Cardiovascular Surgery, the First Hospital of Handan , Handan 056002，Hebei, P.R.China;
Pulmonary metastasis; Diagnosis; Surgical treatment
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Objective To investigate the diagnosis, indications for surgery, operative methods and prognostic factors of surgical resection for pulmonary metastases, and improve the survival rate of patients with pulmonary metastases . Methods A total of 125 patients with pulmonary metastases underwent 138 metastasectomies,116 patients had metastasectomy once while 5 patients underwent a second metastasectomy and 4 patients a third metastasectomy. There were 66 wedge resections,2 segmentectomies, 53 lobectomies,2 en bloc resections of chest wall plus lobectomy,3 pneumonectomies and 12 precision resections. Surgical approaches included 130 thoracotomies and 8 videoassisted thoracic surgery. Results The primary tumor sites were epithelial in 94 patients ,sarcoma in 26 and others in 5. There was no perioperative mortality. A total of 122 patients were followed up , followup time was 1-10 years. The 1-, 3-, and 5-year survival rates were 90.4%, 53.3%, and 34.8% respectively. Better prognoses were found in patients with colorectal cancer, renal cancer and soft tissue sarcoma, the 5-year survival rates were 43.8%, 37.5%, and 33.3% respectively. For the 105 patients whose pulmonary metastases were resected completely, the 5-year survival rate was 38.9%. The 5-year survival rate was only 16.7% for 20 patients with incomplete resection, however. Systematiclymph node dissection had been performed in 89 patients but metastases were identified only in 12 patients. The 5-year survival rates were 14.3% for node positive patients and 41.5% for node negative patients. Conclusion Surgical resection for pulmonary metastases should be performed in properly selected patients and successful outcomes can be achieved. Posterolateral minithoracotomy is the most common surgical approach. The completeness of resection and the status of mediastinal lymph nodes may be important prognostic factors.

Citation： YANG Longhai,LI Junpeng,YE Bo,et al .. The Diagnosis and Surgical Treatment for Pulmonary Metastases. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2009, 16(1): 6-9. doi: Copy