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Cumulative survival in a series of 142 patients undergoing 163 pulmonary resections for metastatic malignant disease is 30% at five years, a statistic that is slightly higher than survival for 820 cases of resection for primary lung carcinoma at the same institution (26%). Removal of pulmonary metastases continues to be a relatively safe approach with hospital mortality of 1.2% and low operative morbidity. Unfavorable predictors, if primary disease is under control, are limited. The primary ones include extent of disease requiring pneumonectomy, melanomatous disease, and appearance of the metastasis antedating knowledge of the primary. An aggressive approach to removal of pulmonary metastases merits continued consideration.
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