Surgery for Lung Metastases
The lungs are a common target-organ for metastases in most of cancers. Pulmonary metastasectomy can potentially be a curative surgical option as long as selection criteria of patients are rigorously met. These essential requirements include control of the primary tumor, no other distant metastatic disease, a limited number of pulmonary metastases so that a complete resection can be accomplished, and adequate performance status of the patient
Depending on the size of the cancerous tumor in the lung, your overall health and cancer staging, your surgeon will decide how much of your lung to remove. The options include:
- Lobectomy: Removal of one or two lobes. The left lung has two lobes, and the right lung has three lobes.
- Pulmonary lobectomies are often required to remove whole pulmonary tumors. Pulmonary lobectomy is a safe and applicable surgical procedure for metastatic lung tumors when long survival is expected after the tumor resection.
- Segmentectomy: A segment, which is part of the lobe, is removed.
- A segmentectomy may be performed as an alternative to a lobectomy—a procedure in which a large piece (lobe) is removed from the lung—as long as the cancer is contained within a small area. It is not used as often for metastatic lung tumors, however, has a well-accepted role for certain primary cancers, in particular colorectal cancer.
- Wedge resection: A wedge is the smallest part of the lung that can be removed. This involves removal of just the tumor and some of the tissue around it.
- A pulmonary wedge resection is a surgical procedure to take out a tumor in the lung and some of the surrounding tissue. A small, triangle-shaped slice of the lung is removed. Wedge resection should be reserved for tumor involving many lobes or for neoplasms having a demonstrated sensitivity to chemotherapy and irradiation.
Surgery, when possible, will likely be used in combination with chemotherapy, immuno-oncology, radiation, and interventional radiology procedures. A multidisciplinary team approach is an absolute must!