Lung oligometastatic disease: redefining cancer pathogenesis from a surgical perspective

Cancer is one of the leading causes of death worldwide. In more than 90% of cases, patients die as a consequence of development of metastases, the diffusion of cancer cells in distant organs from the primary tumor site. This process, which accounts for the high mortality of patients with this condition, is one of the less understood steps of cancer behaviour. In a minority of cases, metastases occur with a limited pattern, rendering them amenable of surgical resection. The lung is a frequent site of metastases and surgical metastasectomy turns out curative in almost 50% of patients. This thesis investigated many aspects concerning the practice of pulmonary metastasectomy, with a peculiar focus on the relationship between cancer, the nutritional status and the immune function of the patients. Indeed, the practice of metastasectomy offers an ideal model to understand some aspects of cancer pathogenesis.