title: Surgical treatment for pulmonary metastases in urogenital cancers.
abstract: BACKGROUND
  The malignant disease's ability to metastasize remains one of the major obstacles when treating patients with cancer. The indication of metastasectomy is currently limited to patients undergoing treatment of the primary tumor. Resections for lung metastases of high selected patients with urogenital cancer present minimal risks and can prolong survival. Prognostic factors that determine which patients will benefit from surgery are still unclear.
  
  
  RESULTS
  This article presents a retrospective analysis of patients who underwent lung metastases resection between 2008 and 2013 in our clinic. Among 148 patients, 8 (5.41%) had lung metastases after urologic cancers (UC), 18 (12.16%) after genital cancers (GC), 13 (8.78%) after breast tumors and 109 (73.65%) had lung metastases from other type of tumors. The overall 6 months survival was 100% for UC, 94.44 for GC, 84.62% for BC and 87.16% for others.
  
  
  CONCLUSIONS
  The criteria for surgery proved to have a positive predictive value and what should be considered are the following: prolonged disease-free interval (DFI), unilateral disease, the absence of systemic pathologies, oncological margins resecability and less than 3 radioimagistic detectable metastases. A negative prognosis was observed in those with primary tumor in the cervix, at least 3 metastases and a tumor larger than 3 cm. To determine how to select surgical candidates for pulmonary metastasectomy more precisely, further analysis of prognostic factors is evident and the need for a prospective, randomized, multicenter study is clear.
authors.affiliation: Clinic of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest.
authors.forename: I M
authors.initials: IM
authors.lastname: Radulescu
authors.affiliation: Urology Department, "Dr. Carol Davila" Central Military University Emergency Hospital, Bucharest.
authors.forename: R
authors.initials: R
authors.lastname: Popescu
authors.affiliation: Obstetrics and Gynecology Department, University Emergency Hospital, Bucharest.
authors.forename: M M
authors.initials: MM
authors.lastname: Cirstoiu
authors.affiliation: Clinic of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest.
authors.forename: I
authors.initials: I
authors.lastname: Cordos
authors.affiliation: Urology Department, "Dr. Carol Davila" Central Military University Emergency Hospital, Bucharest.
authors.forename: D
authors.initials: D
authors.lastname: Mischianu
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, University Emergency Hospital, Bucharest.
authors.forename: C F
authors.initials: CF
authors.lastname: Cirstoiu
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000556:secondary* / Q000601:surgery*; D011379:Prognosis; D013510:Pulmonary Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D014565:Urogenital Neoplasms / Q000473:pathology*
keywords: pulmonary metastases; pulmonary resection; urogenital cancer