The Diagnosis and Surgical Treatment for Solitary Pulmonary Metastases: A Report of 156 Cases

• Main Authors: Hui ZHANG, Xiaofeng CHEN, Haibing WANG, Lei ZHANG, Wenyong ZHOU, Mingchuan ZHAO
• Format: Article
• Language: zho
• Published: Chinese Anti-Cancer Association; Chinese Antituberculosis Association 2012-04-01
• Series: Chinese Journal of Lung Cancer
• Subjects: Lung neoplasms; Metastasis; Surgery; Diagnosis; Prognosis
• Online Access: http://dx.doi.org/10.3779/j.issn.1009-3419.2012.04.06

Background and objective In recent years, it has been proven that surgical treatment for solitary pulmonary metastases has achieved satisfactory results. Consequently, the study aims to investigate the diagnosis, indications for surgery, operative techniques, and prognostic factors of the surgical resection for solitary pulmonary metastases, and to improve the survival rate of patients with pulmonary metastases. Methods The medical records of 156 patients with surgical procedures at our institution were retrospectively reviewed. Results The primary tumors were verified as cancer in 134 cases, sarcoma in 21, and 1 contained unknown tissue. There was no perioperative mortality. A total of 153 patients returned for follow up. Follow-up time was 1 yr to 10 yr. The 5-year survival rates were 31.2%. The median survival time was 35.8 months. Systematic lymph node dissection was performed in 113 patients. The 5-year survival rates were 12.5% for lymph node-positive patients and 37.3% for lymph node–negative patients. The patients who underwent lobectomies had better survival rates, with a 5-year survival rate of 38.5%. Conclusion Surgery is recommended for patients with solitary pulmonary metastasis if they fulfill the surgical indications and favorable outcomes can be achieved. VATS can be chosen for the patients. Hilar and mediastinal lymph node involvement and the surgical approach are potentially important prognostic factors.