B44. Surgery of metastases

The presence of distant metastases often means stage IV and incurable cancer. In general, surgical removal of metastases, so-called metastasectomy, is not a good choice because it’s unlikely to get rid of all the cancer cells, making recurrence highly likely.

However, in some cases distant metastases still allows for potential cure. In other cases, the disease is incurable, but surgery of metastases can be indicated anyway for palliation.

Metastasis surgery with curative intent

The classic example of surgery for metastases with curative intent is resection of liver or lung metastases in case of metastatic colorectal cancer.

Metastasis surgery with palliative intent

Metastases in certain sites are indications for surgery. Some of them are also considered medical emergencies. Examples include:

• Spinal cord or cauda equina compression
• Brain metastases
• Pathologic fracture
• Ileus