[Clinical analyses of surgical treatment for lung metastatic tumors].

OBJECTIVE:To evaluate the distribution, diagnosis, indication and modus operandi of surgical treatment and prognostic factors for patients with lung metastatic tumors. METHODS:The clinical features were collected for 329 surgical patients with lung metastatic tumors during March 1998 and December 2013. Survival analysis was also performed by Log-rank test and Cox-regression analysis. RESULTS:The origins were epithelial tissue tumors (n = 278), sarcomas (n = 32), germ cell tumors (n = 3), malignant melanoma (n = 3) and miscellaneous tumors (n = 13). Their 1, 3 and 5-year survival rates were 85.1％, 50.9％ and 37.1％ respectively with a median survival time of 38 months. Log-rank survival analysis showed that resection extent (P = 0.004), lymph node dissection (P = 0.017) and radical operation (P < 0.01) were significantly associated with patient survival. And multi-variable Cox-regression analysis showed that lymph node dissection and radical operation were two independent prognostic factors. CONCLUSION:For lung metastatic tumor patients with well-controlled primary malignancy and non-metastasis of other organs, radical resection should be performed with minimal resection extent. And routine systematic lymph node dissection is not recommended. The necessity of lymph node dissection should be determined by radiological evaluations and surgical explorations.