What are the patient selection criteria for metastasectomy (wedge resection) to treat secondary lung tumors?

Updated: Feb 08, 2019
  • Author: Daniel S Schwartz, MD, MBA, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Patient selection

In general, good surgical candidates for pulmonary metastasectomy meet all of the following criteria:

  • No other known extrapulmonary metastases - If additional metastases are present, they should be considered amenable to surgical or some other form of therapy
  • Good surgical candidates from the standpoint of cardiopulmonary and other comorbid conditions
  • The location of the metastatic lesion is such that it can be completely resected with reasonable (depending on baseline pulmonary status) preservation of the remaining normal lung
  • The primary tumor site has been controlled or resected

Sometimes the resection is done to confirm the diagnosis (eg, to rule out a new primary cancer that might require a different approach to therapy).

A retrospective series from the National Cancer Institute spanning the period from 1979 to 2010 reported that given the dearth of effective systemic therapies, pulmonary metastasectomy may be the most beneficial treatment in patients who meet established selection criteria. [34]


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