PULMONARY METASTASES: RESULTS OF SURGICAL RESECTION IN 60 CASES: TREATMENT MODALITIES OTHER THAN SURGERY ARE NEEDED

Pulmonary metastases occur in 30% of all oncology patients. Surgical resection of lung metastases is a widely accepted procedure but long-term results are disappointing with a 5-year survival rate of 20-40% and the results vary with the histologic type of the primary tumor. Due to unavailability of any study regarding pulmonary metastasectomy in Iran and emergence of new treatment modalities, reassessment of our current practices is essential. We performed a retrospective study of 60 cases of pulmonary metastasectomy during a 5-year period in one of the major thoracic surgery centers in Tehran (Imam Khomeini Hospital). Bilateral metastases were present in 23% of cases, number of metastases in each patient ranged from 1-12. Average disease-free interval was 12 months, pneumonectomy rate was 21.7% mostly as a second or third attempt and finally, recurrence or death following initial metastasectomy occurred in 12-18 months in most patients. These results confirm that surgery remains unsuccessful in obtaining long-term survival or cure in most patients with pulmonary metastases and treatment strategies other than surgery, such as radiofrequency ablation are needed to avoid performing multiple operations in these patients and improving their quality of life.