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Pulmonary metastasectomy is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In this chapter, we discuss the state-of-the-art thoracic surgery in surgical management of lung metastases. The principles of pulmonary metastasectomy, followed by a comparison between thoracotomy and mini-invasive surgery are presented. Different surgical indications, and oncological outcomes according to the surgical approach (open vs mini-invasive), histological types and the number of metastatic nodules in the lung are discussed. Finally, the role of surgical margin, lymphadenectomy, and surgical resection of recurrent metastases along with a brief overview of the future perspectives in thoracic surgery in the treatment of lung metastases are presented.
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