Surgical Resection of Metastatic Disease

The resection of isolated metastases in patients with solid malignancies should always be a consideration when technically feasible. The term isolated metastasis implies that there are no other sites of metastatic disease present as assessed by clinical and imaging modalities. Hence, the selection of candidate patients for surgical resection requires a thorough evaluation of the individual's disease status, preoperative medical status, and assessment of the feasibility of resecting the metastatic site with a negative margin. This process ends up identifying a small subset of patients who would be surgical candidates. Although there are no prospective randomized

TABLE 4.2. Randomized trials evaluating elective versus therapeutic lymphadenectomy (Level 1 evidence).





No. of patients

Randomized groups

F/U period


Fisher et al.

Vandenbrouck et al.

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