Skip to main content
Log in

Lungenmetastasen – Onkologische Bedeutung und Therapie

Lung metastases—oncological significance and treatment

  • Leitthema
  • Published:
Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Hintergrund

Die Lunge ist ein häufiger Ort der Metastasierung bei einer Vielzahl unterschiedlicher Tumorerkrankungen.

Fragestellung

Darstellung der Inzidenz, Diagnostik, Therapie und Prognose von Lungenmetastasen.

Material und Methode

Sichtung der relevanten Literatur über öffentlich zugängliche Datenbanken (u. a. PubMed, Embase) und Bewertung im multidisziplinären Expertenkreis

Ergebnisse

Die Lungenmetastasierung bedarf einer differenzierten und spezialisierten radiologischen und histopathologischen Bewertung. Es stehen zahlreiche wirksame lokal-ablative und systemische Behandlungsverfahren zur Verfügung.

Schlussfolgerung

Der Beitrag gibt eine multidisziplinäre ausgerichtete Übersicht über Diagnose- und Therapieoptionen bei Lungenmetastasen

Abstract

Background

The lung is a common site of metastasis in numerous cancers.

Objective

To present the incidence, diagnosis, treatment, and prognosis of pulmonary metastases.

Materials and methods

Review of relevant literature via publicly available databases (including PubMed and Embase) and evaluation in a multidisciplinary expert panel.

Results

Pulmonary metastasis requires differential and specialized radiologic and histopathologic evaluation. Numerous effective local ablative and systemic treatment modalities are available.

Conclusion

This article provides a multidisciplinary focused review of diagnostic and treatment options for pulmonary metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Köhler D, Schönhofer B, Voshaar T (2010) Pneumologie. Thieme, Stuttgart, S 241 ISBN 978-3-13-146281‑7.

    Google Scholar 

  2. Suster S, Moran C (2013) Metastatic tumors to the lung. In: Biopsy interpretation of the Lung. Wolters Kluwer, S 369–401. ISBN 978-0-7817-8467‑2

    Google Scholar 

  3. Suster S, Moran C (2012) Neoplasms, metastatic. In: Diagnostic pathology, thoracic. Amirsys, S I‑3-2–I-3-33. ISBN 978-1-931884-49‑5

    Google Scholar 

  4. Vliegenthart R, Fouras A, Jacobs C, Papanikolaou N (2022) Innovations in thoracic imaging: CT, radiomics, AI and x‑ray velocimetry. Respirology 27(10):818–833. https://doi.org/10.1111/resp.14344

    Article  PubMed  PubMed Central  Google Scholar 

  5. Brandman S, Ko JP (2011) Pulmonary nodule detection, characterization, and management with multidetector computed tomography. J Thorac Imaging 26(2):90–105

    Article  PubMed  Google Scholar 

  6. Vogl TJ, Eckert R, Naguib NN, Beeres M, Gruber-Rouh T, Nour-Eldin NA (2016) Thermal ablation of colorectal lung metastases: retrospective comparison among laser-induced thermotherapy, radiofrequency ablation, and microwave ablation. AJR Am J Roentgenol 207(6):1340–1349

    Article  PubMed  Google Scholar 

  7. Hirsch FW, Sorge I, Vogel-Claussen J, Roth C, Gräfe D, Päts A, Voskrebenzev A, Anders RM (2020) The current status and further prospects for lung magnetic resonance imaging in pediatric radiology. Pediatr Radiol 50(5):734–749

    Article  PubMed  PubMed Central  Google Scholar 

  8. Jurmeister P, Schöler A, Arnold A, Klauschen F, Lenze D, Hummel M, Schweizer L, Bläker H, Pfitzner BM, Mamlouk S, Sers C, Denkert C, Stichel D, Frost N, Horst D, von Laffert M, Capper D (2019) DNA methylation profiling reliably distinguishes pulmonary enteric adenocarcinoma from metastatic colorectal cancer. Mod Pathol 32(6):855–865

    Article  CAS  PubMed  Google Scholar 

  9. Jurmeister P, Vollbrecht C, Behnke A, Frost N, Arnold A, Treue D, Rückert JC, Neudecker J, Schweizer L, Klauschen F, Horst D, Hummel M, Dietel M, von Laffert M (2019) Next generation sequencing of lung adenocarcinoma subtypes with intestinal differentiation reveals distinct molecular signatures associated with histomorphology and therapeutic options. Lung Cancer 138:43–51

    Article  PubMed  Google Scholar 

  10. Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, Escriu C, Peters S, ESMO Guidelines Committee (2017) Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 28(suppl_4):iv1–iv21

    Article  CAS  PubMed  Google Scholar 

  11. Murakawa T (2021) Past, present, and future perspectives of pulmonary metastasectomy for patients with advanced colorectal cancer. Surg Today 51(2):204–211

    Article  PubMed  Google Scholar 

  12. Okumura T, Boku N, Hishida T, Ohde Y, Sakao Y, Yoshiya K, Higashiyama M, Hyodo I, Mori K, Kondo H (2017) Surgical outcome and prognostic stratification for pulmonary metastasis from colorectal cancer. Ann Thorac Surg 104(3):979–987

    Article  PubMed  Google Scholar 

  13. Meacci E, Nachira D, Congedo MT, Porziella V, Chiappetta M, Ferretti G, Iaffaldano A, Ciavarella LP, Margaritora S (2017) Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience. J Thorac Dis 9(Suppl 12):S1267–S1272

    Article  PubMed  PubMed Central  Google Scholar 

  14. Marulli G, Mammana M, Comacchio G, Rea F (2017) Survival and prognostic factors following pulmonary metastasectomy for sarcoma. J Thorac Dis 9(Suppl 12):S1305–S1315

    Article  PubMed  PubMed Central  Google Scholar 

  15. Shiono S (2021) The role of pulmonary metastasectomy for pulmonary metastasis from head and neck cancer. J Thorac Dis 13(4):2643–2648

    Article  PubMed  PubMed Central  Google Scholar 

  16. Girelli L, Locati L, Galeone C, Scanagatta P, Duranti L, Licitra L, Pastorino U (2017) Lung metastasectomy in adenoid cystic cancer: Is it worth it? Oral Oncol 65:114–118

    Article  PubMed  Google Scholar 

  17. Kanzaki R, Fukui E, Kanou T, Ose N, Funaki S, Minami M, Shintani Y, Okumura M (2021) Preoperative evaluation and indications for pulmonary metastasectomy. J Thorac Dis 13(4):2590–2602

    Article  PubMed  PubMed Central  Google Scholar 

  18. Schlachtenberger G, Doerr F, Menghesha H, Lauinger P, Wolber P, Sabashnikov A, Popov AF, Macherey-Meyer S, Bennink G, Klussmann JP, Wahlers T, Hekmat K, Heldwein MB (2022) Patients with pulmonary metastases from head and neck cancer benefit from pulmonary metastasectomy, a systematic review. Medicina 58(8):1000

    Article  PubMed  PubMed Central  Google Scholar 

  19. Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam JB Jr (1997) International registry of lung metastases. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113(1):37–49

    Article  CAS  PubMed  Google Scholar 

  20. Bong CY, Smithers BM, Chua TC (2021) Pulmonary metastasectomy in the era of targeted therapy and immunotherapy. J Thorac Dis 13(4):2618–2627

    Article  PubMed  PubMed Central  Google Scholar 

  21. Handy JR, Bremner RM, Crocenzi TS, Detterbeck FC, Fernando HC, Fidias PM, Firestone S, Johnstone CA, Lanuti M, Litle VR, Kesler KA, Mitchell JD, Pass HI, Ross HJ, Varghese TK (2019) Expert consensus document on pulmonary metastasectomy. Ann Thorac Surg 107(2):631–649

    Article  PubMed  Google Scholar 

  22. Gonzalez M, Brunelli A, Szanto Z, Passani S, Falcoz PE (2021) Report from the European society of thoracic surgeons database 2019: current surgical practice and perioperative outcomes of pulmonary metastasectomy. Eur J Cardiothorac Surg 59(5):996–1003

    Article  PubMed  Google Scholar 

  23. Panagiotopoulos N, Patrini D, Lawrence D, Scarci M, Mitsos S (2018) Pulmonary metastasectomy and laser-assisted resection. J Thorac Dis 10(Suppl 17):S1930–S1933. https://doi.org/10.21037/jtd.2018.05.08

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rusidanmu A, Chin W, Xu J, Wang L, He Z, Lv X, Hu J (2021) Does a thoracoscopic approach provide better outcomes for pulmonary metastases? J Thorac Dis 13(4):2692–2697

    Article  PubMed  PubMed Central  Google Scholar 

  25. Adebahr S, Hechtner M, Schräder N, Schimek-Jasch T, Kaier K, Duncker-Rohr V, Gkika E, Momm F, Gaertner J, Becker G, Grosu AL, Nestle U (2019) Early impact of pulmonary fractionated stereotactic body radiotherapy on quality of life:benefit for patients with low initial scores (STRIPE trial). J Thorac Oncol 14(3):408–419

    Article  PubMed  Google Scholar 

  26. Gomez DR, Tang C, Zhang J, Blumenschein GR Jr, Hernandez M, Lee JJ, Ye R, Palma DA, Louie AV, Camidge DR, Doebele RC, Skoulidis F, Gaspar LE, Welsh JW, Gibbons DL, Karam JA, Kavanagh BD, Tsao AS, Sepesi B, Swisher SG, Heymach JV (2019) Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase II, randomized study. J Clin Oncol 37(18):1558–1565

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Harrow S, Palma DA, Olson R, Gaede S, Louie AV, Haasbeek C, Mulroy L, Lock M, Rodrigues GB, Yaremko BP, Schellenberg D, Ahmad B, Senthi S, Swaminath A, Kopek N, Liu M, Schlijper R, Bauman GS, Laba J, Qu XM, Warner A, Senan S (2022) Stereotactic radiation for the comprehensive treatment of oligometastases (SABR-COMET): extended long-term outcomes. Int J Radiat Oncol Biol Phys 114(4):611–616

    Article  PubMed  Google Scholar 

  28. Akanda ZZ, Neeson PJ, John T, Barnett S, Hanna GG, Miller A, Jennens R, Siva S (2021) A narrative review of combined stereotactic ablative radiotherapy and immunotherapy in metastatic non-small cell lung cancer. Transl Lung Cancer Res 10(6):2766–2778

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Rieber J, Streblow J, Uhlmann L, Flentje M, Duma M, Ernst I, Blanck O, Wittig A, Boda-Heggemann J, Krempien R, Lohaus F, Klass ND, Eble MJ, Imhoff D, Kahl H, Petersen C, Gerum S, Henkenberens C, Adebahr S, Hass P, Schrade E, Wendt TG, Hildebrandt G, Andratschke N, Sterzing F, Guckenberger M (2016) Stereotactic body radiotherapy (SBRT) for medically inoperable lung metastases‑A pooled analysis of the German working group “stereotactic radiotherapy”. Lung Cancer 97:51–58

    Article  PubMed  Google Scholar 

  30. García-Mulero S, Alonso MH, Pardo J, Santos C, Sanjuan X, Salazar R, Moreno V, Piulats JM, Sanz-Pamplona R (2020) Lung metastases share common immune features regardless of primary tumor origin. J Immunother Cancer 8(1):e491

    Article  PubMed  PubMed Central  Google Scholar 

  31. Oldenburg J, Berney DM, Bokemeyer C, Climent MA, Daugaard G, Gietema JA, De Giorgi U, Haugnes HS, Huddart RA, Leão R, Sohaib A, Gillessen S, Powles T, ESMO Guidelines Committee (2022) Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 33(4):362–375

    Article  CAS  PubMed  Google Scholar 

  32. Rapoport BL, Shannon VR, Cooksley T, Johnson DB, Anderson L, Blidner AG, Tintinger GR, Anderson R (2021) Pulmonary toxicities associated with the use of immune checkpoint inhibitors: an update from the immuno-oncology subgroup of the neutropenia, infection & myelosuppression study group of the multinational association for supportive care in cancer. Front Pharmacol 12:743582

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Haanen J, Obeid M, Spain L, Carbonnel F, Wang Y, Robert C, Lyon AR, Wick W, Kostine M, Peters S, Jordan K, Larkin J, Guidelines Committee ESMO (2022) Management of toxicities from immunotherapy: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. https://doi.org/10.1016/j.annonc.2022.10.001

    Article  PubMed  Google Scholar 

  34. Swain SM, Nishino M, Lancaster LH, Li BT, Nicholson AG, Bartholmai BJ, Naidoo J, Schumacher-Wulf E, Shitara K, Tsurutani J, Conte P, Kato T, Andre F, Powell CA (2022) Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. Cancer Treat Rev 106(102378):2022–2012. https://doi.org/10.1016/j.ctrv.2022.102378

    Article  CAS  Google Scholar 

  35. Powell CA, Modi S, Iwata H, Takahashi S, Smit EF, Siena S, Chang DY, Macpherson E, Qin A, Singh J, Taitt C, Shire N, Camidge DR (2022) Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies. ESMO Open 7(4):100554

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Florian Lordick.

Ethics declarations

Interessenkonflikt

F. Lordick berichtet Vortragshonorare von Art Tempi, AstraZeneca, Servier, Bristol-Myers Squibb, Daaichi Sankyo, Eli Lilly, Falk Foundation, Incyte, Medscape, Merck KGaA, Merck Sharp & Dohme, Novartis, Roche, Servier und StreamedUp; Beraterhonorare von Amgen, Astellas Pharma, Biontech, Bristol-Myers Squibb, Merck Sharp and Dohme; institutionelle Forschungsunterstützung durch AstraZeneca, Bristol-Myers Squibb, Gilead und Iomedico. S. Krämer, H. Bläker, T. Denecke, N. Nicolay und M. von Laffert geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krämer, S., Bläker, H., Denecke, T. et al. Lungenmetastasen – Onkologische Bedeutung und Therapie. Z Pneumologie 20, 273–283 (2023). https://doi.org/10.1007/s10405-023-00520-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10405-023-00520-1

Schlüsselwörter

Keywords

Navigation