Prognostic factors and survival after resection of lung metastases from epithelial tumours.

Lung metastasectomy is an accepted treatment for selected patients with pulmonary metastases. Resectability, disease-free interval and number of metastases are well characterised prognostic indicators after lung metastasectomy. Patients treated with lung metastasectomy for epithelial tumours were retrospectively reviewed. One hundred and forty-two patients were reviewed. The rate of mediastinal node metastases was 12%. Overall 5-year survival rate was 36% with a median survival time of 47 months. Recurrence rate after lung metastasectomy was 50%. Five-year disease-free survival was 26% with a median of 29 months. Mediastinal nodal status negatively affected survival at univariate analysis (5-years 32% for N+ and 40% for N-, P=0.013). Disease-free survival was significantly different according to nodal status: 5-year disease-free survival 17 and 28% for N+ and N-, respectively (P=0.053). Systemic recurrences were more frequent in patients with nodal involvement (P=0.058). Mediastinal nodal involvement resulted in a significant prognostic factor at multivariate analysis (N+: RRD=3.0; 95% CI 1.3-6.7). Patients with pulmonary metastases and nodal involvement had a poor prognosis and relapsed early after pulmonary metastasectomy. Nodal status should be considered in the selection of patients for lung metastasectomy.