Zusammenfassung
Lungenmetastasen extrathorakaler Primärtumoren können im Stadium der Oligometastasierung komplett reseziert werden, um die Prognose des Patienten zu verbessern. Die Operationsentscheidung ist für jeden Patienten individuell und sollte interdisziplinär, unter Berücksichtigung aller Prognosefaktoren, erfolgen. Eine kurative Resektion erfordert die makroskopische und mikroskopische R0-Resektion unter Einhaltung eines Sicherheitsabstandes entsprechend dem Radius der Metastase in alle Richtungen. Einzelne Herde können per VATS, multiple Herde eher offen mit Palpation der Lunge entfernt werden. Bei multiplen Herden hat die Elektro- oder Laser-Enukleation technische und prognostische Vorteile. Eine systematische Lymphadenektomie sollte bei Metastasen von kolorektalen Karzinomen, Nierenzellkarzinom- und von Keimzelltumoren durchgeführt werden, bei allen anderen Histologien sollte mindestens ein Sampling erfolgen. Damit können Überlebensraten von 20–50 % nach 5 Jahren erreicht werden.
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Welter, S., Balke, D. (2023). Lungenmetastasen. In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59146-8_38
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