Lung Metastases: Current Surgical Indications and New Perspectives

Abstract

Pulmonary metastasectomy is an established treatment that can provide improved long- term survival for patients with metastatic tumor(s) in the lung. In this mini-review, we discuss the state of the art of thoracic surgery in surgical management of lung metastases which actually occurs for a large part of surgical activity in thoracic surgery department. We describe the principles of surgical therapy that have been defined across the time, and that should remain the milestones of lung metastases treatment: a radical surgery and an adequate lymphadenectomy. We then focus on current surgical indications and report the oncological results according to the surgical approach (open vs. mini-invasive), the histological type and number of lung metastases, and in case of re-metastasectomy. Finally, we conclude with a brief overview about the future perspectives in thoracic surgery in treatment of lung metastases.

Pulmonary metastasectomy—is the extent of resection worth reconsidering?

“…In particular, only a small number of studies have focused on outcomes after LAS. The same applies to the modality of resecting metastases by means of radial stapler ( 3 ).…”

“…Depending on the size and clinical focus of the particular department, lung metastasectomy can account for up to 25% of thoracic surgery procedures ( 2 ). In carefully selected patients resections can be associated with prolonged relapse-free survival and cure ( 3 ). Resection even in repeat settings or in cases of simultaneous liver and lung affection has become a widely accepted treatment for appropriately selected patients.…”

Effects of Osimertinib Combined With Pulmonary Rehabilitation and Health Care Training on Pulmonary Function, Complications, and Quality of Life in Patients After Radical Resection of Lung Cancer

“…(5) Patients who were not malnourished; (6) Patients who had an expected survival time of more than 6 months; (7) The Karnofsky performance status score was more than 60 points in patients; (8) The age of the patients was more than 18 years old; and (9) Patients who had good tolerance and compliance. In the following circumstances, patients were not included in this study: (1) Patients with some factors such as hearing impairment, language disorders, unconsciousness or mental illness, and patients who could not communicate with others; (2) Patients with a grave organic disease or dysfunction in vital organs; (3) Patients with complications, such as pulmonary infection and respiratory failure; (4) Patients with malnutrition or excessive obesity; (5) Patients with the expected survival period <6 months; and (6) Patients with the training participation rate <80%.…”

“…However, the effects of chemotherapy in patients with NSCLC are unsatisfactory, and patients can only relieve the clinical symptoms through chemotherapy drugs, which cannot effectively improve pulmonary function (7). For patients with NSCLC with the EGFR gene mutation, the T790M mutation will lead to an increase in chemoresistance, and patients who are insensitive to the conventional pemetrexed often get worse after treatment (8). In recent years, the third generation of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) developed by AstraZeneca has been used in the treatment of the NSCLC with the EGFR gene mutation.…”

HS‑1793 inhibits cell proliferation in lung cancer by interfering with the interaction between p53 and MDM2

“…Lung cancer is one of the leading causes of cancer-related death worldwide. Despite great advances in novel treatments over the past few decades, the survival rate is still low compared to that of other cancers ( 1 , 2 ). Non-small cell lung cancer (NSCLC) is the most common form, accounting for 85% of new diagnoses of lung cancer ( 3 , 4 ).…”