Pulmonary metastasectomy: a cross sectional survey

Background: No prospective randomised studies or international guidelines exist for conduct of pulmonary metastasectomy. The aim of this study was to generate general recommendations for the practice of pulmonary metastasectomy through a cross sectional survey of thoracic surgeons. Methods: A panel of international experts who participated in a consensus statement formation on videoassisted thoracoscopic surgery (VATS) lobectomy were approached to participate in the survey. The Delphi methodology consisting of two rounds of voting was used to establish recommendations. Clinical practice was deemed 'recommended' if 50-74% of the experts reached agreement and 'highly recommended' if 75% or more of the experts reached agreement following the second round of voting. Results: Twenty-two experts from 8 countries completed both rounds of standardised questionnaires. Recommendations were reached on all of the 18 questions concerning the role, indications, contraindications, preoperative evaluation, operative strategy, follow-up and alternative treatment strategies for pulmonary metastasectomy. Conclusions: The results of this survey represent a collective agreement among international thoracic surgery experts and establishes general recommendations for the practice of pulmonary metastasectomy.