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ARTICLE |

Surgical Resection for Pulmonary Metastases in Children

James W. Kilman, MD; Marvin W. Kronenberg, AB; James A. O'Neill Jr, MD; Karl P. Klassen, MD
Arch Surg. 1969;99(2):158-165. doi:10.1001/archsurg.1969.01340140030005.
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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

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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