Secondary pulmonary malignancy

After the liver, the lung is the second most common site for metastatic involvement in neoplastic disease. Consequently, 20% to 54% of patients with cancer have pulmonary metastases at some point in the natural history of their disease. In the absence of extrathoracic metastases (similar to 25% of patients with disseminated disease), complete resection is associated with increased survival, regardless of histology. With appropriate patient selection, life expectancy often is improved, and, in some cases, cures are reported with resection alone or in combination with chemotherapy Even in the context of unresectability, surgical forms of palliation often improve quality of life. For other patients (e.g., these with nonseminomatous germ cell tumors), surgery may have a more diagnostic role, such as defining residual disease that is potentially amenable to salvage forms of therapy.