Pulmonary resection for sarcoma metastases.

We use pulmonary resection in patients with metastatic disease confined to the lungs when the primary disease is controlled, when the tumor doubling time of metastases is longer than 40 days, and when there is no evidence of metastases to other viscera. A staged bilateral thoracotomy should be performed when necessary. The size of the lesions and the number of lesions are not contraindications for resection. Pneumonectomy has been performed with gratifying long term results. Treatment in patients who have rapidly progressive metastatic lesions (tumor doubling time less than 40 days) or who have other metastatic disease must be considered experimental. Chemotherapeutic regimens used as adjuncts to pulmonary resection may produce extreme toxicity in this group of patients. This form of therapy must be administered and followed by experienced personnel in a medical center with facilities for close supervision.