Surgical treatment of metastases to the lung and liver.

Abstract

We resected 120 pulmonary metastases in 67 patients and 49 hepatic metastases in 38 patients. After surgical removal of pulmonary metastases, 14 patients survived five years; without surgical therapy, only one patient survived. As for the prognosis, as many as four resected pulmonary metastases are unimportant. In instances of several metastases, resections should be performed carefully and as rarely as possible. After lobectomy, nine patients have survived for five years; after wedge excisions, four patients have survived for five years, and after bilobectomies or pneumonectomy, one patient has survived for five years. If the lungs are the first filter of hematogen metastases, more patients survive for five years than if the liver is the first filter. With a prolonged free interval period, the prognosis is better. The tumor-doubling time must not influence indication. After resection of hepatic metastases, four patients survived for five years. The prognosis is more favorable for patients with solitary metastasis and if local resection will be sufficient. When the primary tumor and hepatic metastases are removed at the same operation, the prognosis is better than in an instance of delayed diagnosis and removal. If the liver is the first hematogen filter for cleaned off cells of the primary tumor, the survival rates are higher than when the lungs are the first filter.