Surgical management of pulmonary metastases.

Pulmonary metastases, especially solitary ones, have been managed surgically over the past 50 years. Resection is recommended for multiple metastases in patients who are capable of tolerating the required procedure, in which all pulmonary metastases can be resected as long as the primary site and extrapulmonary metastases are controlled or controllable, unless there is better treatment offering the same chance of cure for superior palliation. Complete resectability is the most important prognostic indicator, but several authors have found that for some tumors the number of pulmonary nodules, disease-free interval, and tumor doubling time are also important.