The changing role of surgery for pulmonary metastases.

From 1960 to 1977, 663 resections for pulmonary metastases were performed in 448 patients, 202 with a sarcoma and 246 with a carcinoma. The majority of the patients (70%) had wedge resection or segmentectomy. Operative mortality was 1.0% (7 patients in 663 thoracotomies). With the increased effectiveness of chemotherapy in some specific areas--osteogenic sarcoma and carcinoma of the testis, breast, and colon--the role of surgery is changing. Surgery is now indicated to establish the histology of a solitary lesion, resect metastases unresponsive to chemotherapy, and to reclassify lesions that stabilize but do not disappear totally with chemotherapy.