Resection of pulmonary metastases in six patients with disease-free interval greater than 10 years

Background. The relationship between disease-free interval (DFI) and prognosis has been discussed; however, there is little information on long-term DFI. In this study, we surveyed the cases of pulmonary metastases with DFI greater than 10 years. Methods. Between January 1980 and December 1995, we saw 6 patients with DFI greater than 10 years. All the patients had a histopathologic diagnosis of pulmonary metastases based on surgical resection, and the patients’ characteristics and clinical course were reviewed. Results. The median age was 63 years. Primary sites were breast in 2 patients, and one case each of skin, colon, thyroid, and bladder. The numbers of metastases were one in 4 patients and two in 2 patients. The median DFI was 134 months (range, 127 to 235 months). The median tumor-doubling time was 227 days (range, 80 to 815 days). All the patients underwent a lobectomy. Three patients with metastases from the bladder, colon, and breast died of recurrence. One patient with metastasis from the thyroid died of heart failure. Two patients with metastases from breast and skin cancer survived for more than 3 years. Conclusions. Early death occurred regardless of the long DFI, suggesting that intensive follow-up is mandatory for patients with DFI greater than 10 years.