Surgical treatment of isolated pulmonary metastases (retrospective analysis of 22 patients)

  • Hasan Çaylak
  • Orhan Yücel
  • Alper Gözübüyük
  • Cüneyt Aydemir
  • Sedat Gürkök
  • Mehmet Dakak
  • Kuthan Kavaklı
  • Ersin Sapmaz
  • Onur Genç

Received Date: 16.06.2006 Accepted Date: 03.10.2006 Gulhane Med J 2006;48(4):195-199

It is widely accepted that surgical resection is the first-line therapy for isolated pulmonary metastases if the primary site of tumor is under control. In this retrospective study, data of the patients who were operated for metastatic disease of the lung with curative intent over a 8- year-period were analyzed. Pulmonary metastasectomy was performed to 22 patients with isolated pulmonary metastases on 34 surgical procedures between July 1996 and October 2004. The patients were analyzed with respect to the parameters of age, gender, clinical features, histopathologic diagnosis, disease free interval, surgical intervention performed and survival. Nineteen (86%) and 3 (14%) of the patients were male and female, respectively, and their mean age was 28.4 (15-65) years. Osteosarcoma was the most commonly observed histopathologic type with 11 cases. Although a total of 57 metastases were detected preoperatively, 30 additional metastatic lesions were determined by manual examination during operation, and these lesions were also resected. Pulmonary metastasectomy was performed through a posterolateral thoracotomy in 19 (86%) of the patients and video assisted thoracic surgery was used in 3 (14%) of the patients. Although video assisted thoracic surgery is a less invasive procedure for pulmonary metastasectomy, thoracotomy procedure which allows manual examination of the lung parenchyma during operation and detection of the metastatic lesions which can not be detected preoperatively currently deserves its importance.

Keywords: Surgical treatment, intraoperative manual examination, pulmonary metastasectomy