Resection of isolated pulmonary metastasis resulted in surprising longevity in this study by Hornbech et al. They report a series of 248 patients, 97% of whom had a complete resection of their pulmonary metastasis, following them for an average of 5 years. The five year survival rates after pulmonary metastasectomy were as follows:

• Colorectal cancer: 50%

• Renal cell carcinoma: 51%

• Malignant melanoma: 25%

• Sarcoma: 22%

Surgical morbidity and mortality were quite low (again, patients were highly selected). Their data didn't produce any prognostic factors that could be used to risk-stratify patients or predict survival. Given the dearth of other effective treatments for metastatic cancer, authors endorse metastasectomy as an option to be at least considered in patients with pulmonary metastases.

Hornbech K et al. Outcome after Pulmonary Metastasectomy: Analysis of 5 Years Consecutive Surgical Resections 2002–2006. J Thoracic Oncol 2011;6(10):1733-1740.