Wider implications of video-assisted thoracic surgery versus open approach for lung metastasectomy

Lung metastasectomy is considered a safe and potentially curative proceduredespite there is not a strong evidence that metastasectomy prolongs long-term survival inpatients with lung metastases. Moreover, the debate is open regarding the best approach forlung metastasectomy, video-assisted thoracic surgery versus open approach. A systematicreview of literature to clarify what is the best approach to prolong survival in patients withlung metastases was performed. Our study confirms that overall survival is equivalent forvideo-assisted thoracic surgery and thoracotomy, therefore the ‘gold standard’ surgicaltreatment for lung metastases remains a point of debate. The choice of the surgical approachstill depends more on the single center or surgeon practice than on strong scientific evidence.A prospective randomized trial could clarify the question.