Pulmonary Metastasis

Lung Metastases and Isolated Lung Perfusion

Surgical resection of lung metastases is a widely accepted procedure but long-term results are disappointing with a 5-year survival rate of approximately 40%. The main prognostic factor is complete resection and a better survival is reported in patients with a single metastasis and a disease-free survival of more than 3 years. Re-operations are feasible but often patients become inoperable due to insufficient pulmonary reserve and new treatment modalities are looked for. Intravenous (iv) chemotherapy has no major impact on survival due to systemic side-effects when high doses are given. As isolated limb and liver perfusion, isolated lung perfusion (ILuP) has the advantage of selectively delivering an agent into the lung while diverting the venous effluent. This allows the drug to be given in a significantly higher dose compared to iv therapy, while drug levels in the other organs are kept low enough to avoid major complications. ILuP has been shown to be very effective for the treatment of lung metastases in animal models. Phase I clinical studies to determine dose-limiting toxicity and maximum tolerated dose have recently been reported. The principal aim of this book is to discuss the current treatment of lung metastases and the possible contribution of ILuP.

Therapy of Lung Metastases

Metastasis / Dissemination

This volume emphasizes metastasis/dissemination as im nective tissues, muscle, tumours of neuronal origins and portant processes in cancer growth and progression. teratomas. Previous volumes in this series have emphasized aspects of The broad array of neoplastic diseases, multiple target cancer progression, tumor invasion and tumor metastasis sites, and patterns of metastasis and dissemination underlie and the importance of these processes to the pathophysiol the importance of achieving crucial insights into particular ogy and morbidity of malignant disease. This volume builds neoplasms. An understanding of metastasis and dissemina on these earlier themes and emphasizes metastasis/disse tion in man remains an essential objective for the design of mination in man. Following a review of general patterns of new diagnostic and therapeutic strategies for the therapy of metastatic spread in man, metastasis to, or progression of established metastatic disease and spread accompanying neoplasms in several organ systems are highlighted, includ site-specific tumor progression. ing: the central nervous system, esophageal cancer, the lung, the large intestine, the liver, bone, epithelial neoplasms, Series Editor Volume Editor endocrine cells, pigmented tissues, supporting tissues, con- Hans E. Kaiser Elizier L. Gorelik VII ACKNOWLEDGEMENT Inspiration and encouragement for this wide ranging project on cancer distribution and dissemination from a comparative biological and clinical point of view, was given by my late friend E. H. Krokowski.