Prolonged survival after extracranial metastasectomy from synchronous resectable lung cancer

Ann Surg Oncol. 2001 Sep;8(8):663-6. doi: 10.1007/s10434-001-0663-7.


Background: Combined resection of solitary synchronous brain metastases and non-small-cell lung cancer has been shown to be successful. Thus, we proposed combining the surgery of solitary, extracranial metastases, and resectable lung cancer.

Methods: Between March 1987 and December 1994, surgery was performed on nine patients with non-small-cell lung cancer with synchronous, solitary, extracranial, or distant metastasis: adrenal (n = 5), cutaneous (n = 2), axillary lymph node (n = 1) and kidney (n = 1). Criteria for operating on these patients included: primary tumor that was locally resectable in a radical manner, non-small-cell histology, no preoperative evidence of N2 disease, complete resection of histologically proven metastasis, and absence of other metastases found with computed tomography or bone scan.

Results: Resection of the primary tumor and solitary metastases was achieved in all patients. Primary tumor was always resected by lobectomy. No mortality or major morbidity was reported. Five-year survival rate was 55.6%. Five patients who had adrenal (n = 3), or skin (n = 1), or axillary (n = 1) metastases, survived more than 5 years. All N2 patients (n = 2) died.

Conclusions: The presence of solitary, distant metastasis should not be considered, per se, a factor for denying surgery for locally resectable, non-small-cell lung cancer. Unexpected, prolonged survival was demonstrated in our limited series.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Gland Neoplasms / mortality
  • Adrenal Gland Neoplasms / secondary*
  • Adrenal Gland Neoplasms / surgery
  • Aged
  • Axilla
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / secondary*
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Skin Neoplasms / mortality
  • Skin Neoplasms / secondary*
  • Skin Neoplasms / surgery
  • Survival Analysis
  • Treatment Outcome