The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

For patients with extrapulmonary primary malignancies, the lung is the most frequent site of metastatic spread.1 Pulmonary metastatic disease is experienced commonly in colorectal cancer (CRC), sarcomas, melanoma, head and neck cancers, breast cancer, and tumors of the urinary tract, with numerous other malignancies known to additionally spread to the lungs.2,3 Historically, systemic therapy has been considered standard of care for stage IV cancer, given the systemic nature of the disease; however, options for local therapy of metastatic pulmonary nodules are expanding, with substantial evidence for efficacy in terms of optimal local control for prolonging life, delaying recurrence, and enabling patients to experience freedom from chemotherapy.