Criteria for resection of pulmonary metastases

The pulmonary metastases appear to be completely resectable based upon preoperative imaging.

The patient has adequate cardiopulmonary reserve to tolerate resection.

Metastasectomy is technically feasible.

The primary tumor is controlled or controllable.

Extrapulmonary metastatic disease is absent, or if present, the disease must be controllable with surgery or another treatment modality.

Resection of one or more lung lesions may be indicated in those who do not meet the above criteria. As examples:

Symptomatic metastases (eg, bronchial obstruction with distal suppuration) that cannot be managed in any other way.

Tissue needs to be obtained for a novel therapeutic strategy (eg, an autologous vaccine, molecular testing), preferably within the confines of a clinical trial.

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