title: Pulmonary metastases from epithelial tumours: late results of surgical treatment.
abstract: OBJECTIVE
  Development of distant metastases is one of the primary characteristics of malignant tumours. During the last decades, lung metastasectomy has been progressively accepted as a therapeutic option in oncology patients. The present paper aims to evaluate the long-term results and factors influencing prognosis in patients submitted to lung resection for metastases from extrapulmonary epithelial tumours.
  
  
  METHODS
  We retrospectively analysed data of 202 patients undergoing 207 procedures of lung metastasectomy between January 1980 and December 2003. Factors that may influence long-term prognosis such as completeness of resection, histology of the tumour, disease-free interval, number of resected lesions, involvement of hilar or mediastinal lymph nodes, systemic treatments were investigated.
  
  
  RESULTS
  Complete resection was carried out in 169 patients (83.7%). The more frequent lung resection was sublobar in 67.6% of cases, but rarely in selected patients bilobectomy or pneumonectomy has been carried out too. Perioperative morbidity and mortality were 7.7% and 0.9%. Mean disease-free interval was 49+/-48 months. Mean follow-up was 33+/-31 months, 5-year and 10-year survival rates for completely resected patients were 43% and 17%, respectively. By univariate and multivariate analyses, completeness of resection, disease-free interval of 36 months or more, and single resected metastasis were found to be significant prognostic factors.
  
  
  CONCLUSIONS
  Resection of epithelial lung metastases allows an acceptable prognostic result in appropriately selected patients with very low perioperative morbidity and mortality. Factors such as high disease-free interval, single metastasis and completeness of resection are demonstrated and confirmed to be significantly associated with long-term survival.
authors.affiliation: Thoracic Surgery Department, University A. Avogadro, Novara, Italy. ottaviorena@libero.it
authors.forename: Ottavio
authors.initials: O
authors.lastname: Rena
authors.forename: Esther
authors.initials: E
authors.lastname: Papalia
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
authors.forename: PierLuigi
authors.initials: P
authors.lastname: Filosso
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.forename: Giuliano
authors.initials: G
authors.lastname: Maggi
authors.forename: Caterina
authors.initials: C
authors.lastname: Casadio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D011013:Pneumonectomy / Q000379:methods*; D011379:Prognosis; D016896:Treatment Outcome