Unilateral or bilateral approach for unilateral pulmonary metastatic disease

The term pulmonary metastasectomy refers to surgical excision of malignant lesion(s) of the lung of extrapulmonary origin. Several retrospective studies, including the International Registry of Lung Metastases, have observed increased survival following pulmonary metastasectomy when compared to historical control patient cohorts who did not undergo resection. Over the years these observations have led to widespread acceptance of pulmonary metastasectomy in appropriately selected patients. The lack of randomized, controlled trials and the continued evolution in imaging technology, chemotherapeutics, and surgical technique pose significant challenges to clinicians as they struggle with appropriate patient selection for and the optimal surgical approach to metastasectomy.