Surgery Today

, Volume 39, Issue 2, pp 91–97 | Cite as

Current status of pulmonary metastasectomy from primary epithelial tumors

  • Tokujiro Yano
  • Fumihiro Shoji
  • Yoshihiko Maehara
Review Article

Abstract

The resection of pulmonary metastases can prolong the survival of selected patients and its therapeutic value is now accepted. The criteria for eligibility have also evolved. We reviewed the recent literature on pulmonary metastasectomy for various epithelial primary tumors and tried to establish better prognostic indicators for its surgical application. In addition to the welldefined requisites for pulmonary metastasectomy, other requirements include the absence of mediastinal lymph node involvement, a limited number of pulmonary metastatic lesions, a long disease-free interval, small metastasis, and no elevation of tumor markers, although the clinical importance of each factor varies among the primary tumors. On the other hand, with the development of video-assisted thoracoscopic surgery (VATS) and advances in thoracic imaging technology, VATS metastasectomy might become an accepted treatment for metastatic nodules located in the periphery of the lung, which can be easily removed by a wedge resection. Repeat surgery is also possible during follow-up after VATS.

Key words

Pulmonary metastasectomy Epithelial tumor Mediastinal lymph node involvement Disease-free interval Tumor markers 

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Copyright information

© Springer 2009

Authors and Affiliations

  • Tokujiro Yano
    • 1
  • Fumihiro Shoji
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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