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Pulmonary metastasectomy: an overview

  
@article{JTD13620,
	author = {Francesco Petrella and Cristina Diotti and Arianna Rimessi and Lorenzo Spaggiari},
	title = {Pulmonary metastasectomy: an overview},
	journal = {Journal of Thoracic Disease},
	volume = {9},
	number = {12},
	year = {2017},
	keywords = {},
	abstract = {Metastasectomy is the most frequent surgical resection undertaken by thoracic surgeons, being the lung the second common site of metastases. The present oncological criteria for pulmonary metastasectomy are: (I) the primary cancer need to be controlled or controllable; (II) no extrathoracic metastasis—that is not controlled or controllable—exists; (III) all of the tumor must be resectable, with adequate pulmonary reserve; (IV) there are no alternative medical treatment options with lower morbidity. General favourable prognostic features in patients with pulmonary metastases are: (I) one or few metastases; (II) long disease free interval; (III) normal CEA levels in colorectal cancers. Negative predictive features in patients candidate to pulmonary metastasectomies are: (I) active primary cancer; (II) extrathoracic metastases; (III) inability to obtain surgical radicality; (IV) mediastinal lymphatic spread. The lack of controlled trials and studies limited by short follow-up and small cohorts did not allow to overcome some skepticism; moreover, the heterogeneity of these patients in terms of demographic, biologic and histologic characteristics represents a clear limit even in the largest series. On the basis of present knowledge, without results coming from on-going randomized trials, radical resection, histology, and disease free interval seem to be independent prognostic factors identifying a cohort of patients maximally benefitting from lung metastasectomy.},
	issn = {2077-6624},	url = {http://jtd.amegroups.com/article/view/13620}
}