Abstract

It is known that for pulmonary metastasis, cases that had complete surgical resections have longer survival. This study was done armed to search the efficacy and safety of pulmonary metastasectomy and sensitivity of computerized tomography (CT) in the diagnosis of pulmonary metastasis.

Twenty-seven cases whohad been operated for pulmonary metastasis in our clinic between 1996-2000 were evaluated retrospectively. In all cases primary sites of tumors were under control and there were no metastasis elsewhere. Preoperative radiological and cardiopulmonary assessment consideved the complete resection of all metastasis being possible.Posterolateral thoracotomy was puformeol in all cases. Bilateral cases operated sequentially, 3 week intervals. There were eighteen male (% 66,7) and nine female (%33,3) patients. The mean age of was 31,3. Commonest primary pathologies were osteosarcoma (9 cases), other soft tissue sarcoma (6 cases). Five cases were bilateral. Re-metastasectomy was puformeol in 5 patients, one of themhcol twice opuatron (total 38 intervention). In preoperative evaluation by CT, the number of metastases detected was ranged 1 to 12 (mean 2,12) while it was 1 to 67 (mean 5,27) by surpical resatron . CT could identify the correct number only in 18 out of 38 (% 47,3). Four had lobectomy cases (% 10,5) and 3 (% 7,9) had segmentectomy while the rest had excision of metastasis with electrocautery. Mortality was due to cardiac arrestin one cases (% 90), and morbidity to prolonged air leaks in 3 cases ( %7,9). Five cases (18,5%) were out of follow-up. Six cases were died during their follow-up due to recurrence of primary site or metastasis. The remaining 15 cases are still alive. Survival was % 88.2 in 1 year and % 31.5 in 3 years, calculated by Kaplan-Meier test. As a conclusion; survival is increased with surgical resection of lung metastases when the primary site is under control, no metastases found elsewhere and complete resection is possible. CT may detect less number of metastases then the ones resected by thoracotomy.