Surgical Therapy of Metastatic Lung Tumors

Abstract

Although surgical therapy has widely been performed for metastatic lung tumors, any guidelines for the surgical indications and procedures are still absent. As for surgical therapies for metastatic lung tumors, the issues to be discussed in accordance with real clinical settings are largely classified into : 1) criteria for surgical indications ; 2) operative procedures including range of lung resection (wedge resection, lobectomy, or segmentectomy), the significance of regional lymph node dissection, and operative approach (thoracoscopic or open approach) ; 3) therapeutic guidelines by each primary lesion ; and 4) the role of the surgical therapy in the era of multidisciplinary therapy. This review article deals with considerations based on our experiences in our hospital in terms of 1) the history of surgical therapy for metastatic lung tumors as well as time course from the history until we have reached the current surgical indication criteria, and those in our hospital ; 2) changes and current status of operative procedures in our hospital, a comparison with those described in the literature, and consideration of operative procedures used for wedge resection ; 3) changes in outcomes of surgical resection by each primary lesion and by period ; and 4) the role and further perspectives of surgical therapy in the era of multidisciplinary therapy.