Methods: A total of 74 patients (42 males, 32 females; mean age 34 years; range 3 to 73 years) who underwent pulmonary metastasectomy between January 1994 and December 2003 were retrospectively reviewed. Patients were classified according to age, gender, primary histology of tumor, the number of lesions, operative techniques, the number of complete or incomplete resections, mediastinal lymph node involvement, disease free interval and additional therapy. Effects of these prognostic factors to 2 and 5 year-survival were evaluated.
Results: Twelve of the patients (16%) were symptomatic whereas 62 patients (84%) were asymptomatic. Of the 74 patients, metastasis of sarcoma was seen in 41 (56%) and epitelial type tumor in 20 (26%) patients. Complete metastasectomy was performed in 70 patients whereas 4 patients underwent incomplete resection for diagnostic purposes. Mean postoperative hospital stay was 5.7 (4-8 days) and postoperative complication rate was 16%. Mean disease free interval was 16.2 months for sarcomas, 36 months for epitelial tumors, 7.2 months for germ cell tumors, 8.4 months for melanomas and 35.5 months for the other tumors.
Conclusion: Surgical resection of pulmonary metastases is an effective and safe treatment modality. The histopathology of the tumor, disease-free interval, number of metastases, involvement of mediastinum and additional therapy are important prognostic markers. Larger series are needed to find out the clear contribution of the number of metastases to survival.