Zusammenfassung
Zwischen 1975 und 1985 wurden 76 Patienten mit Lungenmetastasen an der Lungenklinik
Hemer operiert. Nach 1 Jahr lebten 86%, nach 3 Jahren 35% und nach 5 Jahren noch 18%.
Die mediane Überlebenszeit (ÜL-Zeit) betrug 22 Monate.
Von prognostischer Bedeutung sind: der Tumortyp, die Zahl der Metastasen, das Intervall
zwischen Primärtumoroperation und Lungenmetastasektomie sowie die Art der Operation.
Voraussetzung für eine Lungenmetastasektomie sind: radikale Entfernung des Primärtumors,
Metastasen nur in der Lunge, technische Operabilität der Metastasen und ein akzeptables
Operationsrisiko. Die Ergebnisse werden insgesamt als ermutigend angesehen.
Abstract
Between 1975 and 1985 76 patients underwent surgery of pulmonary metastases in our
hospital. Most often the primary tumor was located in carcinomas of the colon and
rectum (19 patients), followed by carcinomas of the kidney (14 patients), the breast
(13 patients) and the skin (malignant melanoma: 9 patients). Conditions for pulmonary
metastasectomy are radical removal of the primary tumor, metastases located only in
the lung, resectability of the metastases and low operative risk. Three years after
pulmonary metastasectomy 35 % of the patients were still alive, the 5 year survival
rate was 18%. The median survival time was 22 months. The prognosis in patients with
pulmonary metastases is largely dependant upon tumor type. Pulmonary metastases of
breast carcinomas and carcinomas of colon and rectum can be treated best by surgical
intervention. (5 year survival rate: 35% and 33%). Hypernephroma and malignant melanoma
have a 5 year survival rate of 0% and 23%. Other prognostic factors are the number
of pulmonary metastases and the disease-free interval between surgery of the primary
tumor and pulmonary metastasectomy. Furthermore resection techniques are of prognostic
importance. Lobectomy and segmental resection showed a better 5 year survival rate
than pneumonectomy (21%, 24%, 0%). Median sternotomy is recommended as standard access
for pulmonary metastasectomy. Surgery of pulmonary metastases is encouraging.
Key words
Pulmonary metastases - Surgical treatment - Prognostic factors
