Improvement in the treatment of malignant disease in children has been the result of early aggressive therapy by surgeons, chemotherapists and radiologists. Most technical advances learned in adult cancer therapy have been adapted to pediatric cancer problems. There has been some reluctance, however, to apply the principles of surgical resection of pulmonary metastatic lesions to pediatric patients. The fact that the pulmonary metastasis can be the direct cause of death in the child apparently cured of his cancer is often ignored.1
The child with an adequately treated primary tumor frequently exhibits pulmonary metastases. These children are considered for chemotherapy or radiation therapy or a combination of both. Surgery is not usually considered unless there is a failure of both of these modes of therapy. Surgery may then be impossible due to toxicity from chemotherapy or pulmonary dysfunction secondary to radiation fibrosis.2,3 It would seem that the best answer
Kilman JW, Kronenberg MW, O'Neill JA, Klassen KP. Surgical Resection for Pulmonary Metastases in Children. Arch Surg. 1969;99(2):158–165. doi:10.1001/archsurg.1969.01340140030005
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