Lung Metastasis Surgery and Treatment
Cancer in another organ can spread to the lung, in other words metastasis. In this case, the treatment method to be applied is usually chemotherapy. However, in some cases, the spread (metastasis) in the lung can be removed with surgery.
A lung metastasis is treated by looking at the following features:
- Location of the metastatic mass,
- Number of metastases (one, two or many)
- The general health status of the patient
- Whether the spreading tumor (eg colon cancer) has been treated
The picture shows lung metastasis to the left lung 3 years after the treatment of malignant melanoma in a 39-year-old female patient.
Why is Metastasis Surgery Necessary?
Surgery should always be the first choice in the treatment of lung metastases, because complete removal of metastatic masses and leaving no metastatic mass behind often provides complete cure. Oncology specialists and chest diseases and thoracic surgery specialists should make the surgery decision together. If surgery is the best method for the patient to get rid of this spreading situation, then surgery is applied. If the operation will not create a positive situation for the patient’s health, the operation is not performed.
Which Patients with Lung Metastases Are Operated?
- The metastasizing cancer must be fully treated (with surgery, medication, or radiotherapy). The treating physician should indicate that the main cancer is no longer present in the body (for example, a patient who has undergone surgery and chemotherapy for breast cancer).
- There should be no metastases in any part of the body other than the lung.
- The patient’s respiratory functions should be sufficient for surgery.
- After removal of lung metastases, sufficient lung tissue should remain for a healthy life.
In addition to these, the type of tumor, the length or shortness of the time between the first cancer and the appearance of metastasis, and the parameters related to the general condition of the patient are other important factors in making the surgery decision.
What International Resources Recommend in Lung Metastasis?
Surgical treatment of lung metastases is the method recommended by all international sources, within certain rules. International sources recommend surgical removal of lung metastases as long as possible. It has been shown that the disease-free survival time of patients who underwent surgery and whose metastases were completely removed is much better than those who received medical treatment.
The decision for surgery must be made with the approval of the oncology specialist or the oncology council!
What are the Lung Metastasis Surgery Methods?
- Removal of only the metastatic mass,
- Removing the segment,
- Removal of the lobe it is in, or
- Removal of the entire lung (very rare) may occur.
Removal of metastases by open method is preferred. It is thought that very small metastases may not be seen with closed surgery / endoscopic surgery, that is, VATS method. For this reason, the open method is mostly used in metastasis surgeries. However, today, lung surgeries with the closed method have begun to be performed more successfully.
What are the Risks of Surgery?
- Prolonged air leakage from the lung,
- Bleeding,
- The risks associated with taking narcosis (such as having a heart attack, a clot blocking a vessel) and
- Infection can be counted among the risks.
How Many Days Will You Stay in the Hospital for Surgery?
The average hospital stay for lung metastasis surgery is 3-4 days.
How is Lung Metastasis Surgery Performed?
In the closed method, a 1 cm wide surgical camera is advanced between the ribs. The metastasized area is seen and the metastasized lung section is partially excised with medical instruments advanced from the side of the camera. After the procedure, 1 drain is placed through this incision and the operation is completed.
In the open method, approximately 15 cm between the ribs is opened, and the metastasis in the lung is found manually and removed with the appropriate method.
Will I Need Radiotherapy or Chemotherapy After Surgery?
Chemotherapy and/or radiotherapy can be applied in addition to surgical treatment, depending on the pathology result and whether the lung metastasis is completely removed or not. This is not necessary in every patient.