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Advances in therapy have expanded indications for pulmonary metastasectomy beyond highly selected cases. This study investigated long-term outcomes and prognostic factors of repeated pulmonary metastasectomies in modern clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study analyzed the long-term results of 1503 pulmonary metastasectomies performed on 1106 consecutive patients at the Istituto Nazionale Tumori of Milan between 2003 and 2018, with a focus on multiple and repeated procedures, type of surgical resection, and key prognostic factors. Patients were stratified into three cohorts: single metastasis (SM,\n                      <jats:italic>n<\/jats:italic>\n                      = 530), multiple metastases (MM,\n                      <jats:italic>n<\/jats:italic>\n                      = 595), and recurrent metastases (RM,\n                      <jats:italic>n<\/jats:italic>\n                      = 378).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 10\u00a0year survival rates were 35.5% overall, 41.1% for SM, 30.8% for MM, and 31.1% for RM. The median survivals were as 5.1, 5.4, 3.8, and 5.9\u00a0years respectively. Precision resection was the most common type of procedure (53.2%), with 54.0% survival at 5\u00a0years and 33.4% survival at 10\u00a0years. The 30\u00a0day postoperative mortality was 0.1% overall, 0% for SM, 0.3% for MM, and 0% for RM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight the feasibility and curative potential of multiple and repeated pulmonary metastasectomies for carefully selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-18992-1","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:57:47Z","timestamp":1770821867000},"page":"4313-4323","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Results of Multiple Pulmonary Metastasectomies"],"prefix":"10.1245","volume":"33","author":[{"given":"Michele","family":"Ferrari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Valsecchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Leuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Rolli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Sabia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Pardolesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Stanzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Pastorino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"18992_CR1","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1002\/1097-0142(19860701)58:1<190::AID-CNCR2820580133>3.0.CO;2-5","volume":"58","author":"DA Potter","year":"1986","unstructured":"Potter DA, Kinsella T, Glatstein E. 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