title: Outcome after pulmonary metastasectomy: analysis of 5 years consecutive surgical resections 2002-2006.
abstract: BACKGROUND
  In this study, we analyze the results of management of pulmonary metastases in 5 years consecutive operations at our institution. We aim to define the patients who are most likely to benefit from surgery by investigating long-term survival and prognostic factors associated with prolonged survival.
  
  
  METHODS
  The data on all consecutive patients between 2002 and 2006 were reviewed retrospectively. One hundred seventy-eight patients underwent 256 surgical resections for suspected pulmonary metastases from different primary malignancies. Prognostic factors analyzed included age, sex, surgical approach, surgical resection, number of metastases, distribution of metastases, disease-free interval, presence of synchronous metastases, recurrence of disease, prior liver resection (colorectal cancer), and tumor histology (sarcomas).
  
  
  RESULTS
  Complete resection was achieved in 248 cases (96.8%). The mean follow-up was 61.6 months. Five-year survival with respect to primary malignancy was colorectal carcinoma (50.3%), sarcoma (21.7%), malignant melanoma (25.0%), renal cell carcinoma (51.4%), and miscellaneous malignancies (50.0%). Of the prognostic factors analyzed by univariate analysis, none was found to be significant in all the different groups of cancers.
  
  
  CONCLUSIONS
  Pulmonary metastasectomy is a safe and effective treatment that may be associated with prolonged survival in highly selected patients. Low morbidity and mortality rates in contrast with the lack of any other effective treatment justify the aggressive approach of surgery. Thoracoscopic resection is a valid option in selected patients. In case of recurrence of pulmonary disease and if the patient fulfils the initial criteria for pulmonary metastasectomy, repeat surgery should be performed. Solid prognostic factors still need to be established.
authors.affiliation: Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen East, Denmark. khornbech@hotmail.com
authors.forename: Kåre
authors.initials: K
authors.lastname: Hornbech
authors.forename: Jesper
authors.initials: J
authors.lastname: Ravn
authors.forename: Daniel Andreas
authors.initials: DA
authors.lastname: Steinbrüchel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult