Surgical management of pulmonary metastases

The management of pulmonary metastases remains controversial. More information is available, however, on outcomes in larger series of patients undergoing metastasectomy as well as the indications for the procedure. The role of video-assisted thoracic surgery for the diagnosis and management of these patients is being scrutinized carefully. Isolated perfusion techniques for treating patients with unresectable pulmonary metastases have been applied in phase I and II trials at selected institutions. More data regarding clinical outcomes are necessary, however, before widespread adaptation of this experimental form of treatment is accepted as standard practice.