Surgery in bronchial carcinoma with metastasis.

Two groups of lung cancer patients with solitary M1 disease are presented in whom lung resection was performed at the time of or after operative treatment of the metastasis. Nine patients had solitary brain metastasis prior to the resection of the primary tumor. Six died, with an average survival of 10 months post-thoracotomy, 3 survive after 15 to 31 months. The results are less favorable than suggested by the literature where often cases are included which have brain metastasis after lung cancer surgery. Another eight M1 situations in this series are predominantly lung cancers with pleural disease. Improvement of quality of life and substantial survival times have been observed, though most patients are still at risk after a survival of from 15 to 35 months. As to the histological features, adenocarcinoma was the most frequent type followed by the adenosquamous variant. Lung surgery should be considered in selected cases in spite of known or formerly treated solitary distant metastasis.