title: [Surgery of lung metastasis].
abstract: BACKGROUND
  The 30-40% of the oncologic patients have pulmonary metastases. Lung can be the only organ affected. In selected patients, exeresis of the pulmonary nodules can mean their healing.
  
  
  METHODS
  Between 1982-1997, twenty two patients presented metastases, 13 could be operated and 16 thoracotomies were done. There were 53% boys and 47% girls whose ages ranged from 3 to 15 years. We have considered: pulmonary tumour location, disease free interval, number of metastases, surgical technique and incomplete pulmonary tumour resection.
  
  
  RESULTS
  Primary tumours were: Wilms tumours 23%, bone tumours 67% (Ewing and osteosarcoma). Disease free interval was < 2 years in 8 patients (61%) and > 2 years in 39%. X-Ray and CT were performed in every case and 66% presented a solitary nodule. Surgical techniques were: metastasectomy in two cases (12%), wedge resection in 8 (50%) and lobectomy in six cases (38%). We made thoracoscopy in two patients. There weren't postoperatory mortality but the patients with tumorectomy had an incomplete surgical resection. The overall survival is 54 percent and the 5 years survival is 23 percent (3 patients).
  
  
  CONCLUSIONS
  The patients with a DFI < 2 years have a survival of 25% compared with 100% for patients who have a DFI > 2 years. The pulmonary resection in selected patients can offer better survival. We can use the thoracoscopy in same selected patients.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Universitario Doce de Octubre, Madrid.
authors.forename: M D
authors.initials: MD
authors.lastname: Delgado Muñoz
authors.forename: J L
authors.initials: JL
authors.lastname: Antón-Pacheco
authors.forename: J A
authors.initials: JA
authors.lastname: Matute
authors.forename: J
authors.initials: J
authors.lastname: Cuadros
authors.forename: P
authors.initials: P
authors.lastname: Aguado
authors.forename: J L
authors.initials: JL
authors.lastname: Vivanco
authors.forename: F J
authors.initials: FJ
authors.lastname: Berchi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D012516:Osteosarcoma / Q000556:secondary* / Q000601:surgery*; D009396:Wilms Tumor / Q000556:secondary* / Q000601:surgery*