One hundred and fifty-six thoracic operations have been performed overan 8-year period, from 1980 to 1987, for 118 patients with pulmonarymetastases. In 27 instances, the disease has been bilateral requiring amidline approach or sequential lateral thoracotomies. Resection wasachieved by wedge excision in 74%, lobectomy in 16%, pneumonectomy in 4%,lobectomy plus wedge excision in 2%, bilobectomy in 1%, segmentectomy in 2%and segmentectomy plus wedge excision in 1%. The operative mortality forthe group as a whole was 1.6% per patient (70% confidence limits CL.0.6%-4.2%) and 1.2% per operation (70% CL. 0.5- 3.2%). Actuarial survivalfor the histological subgroups at 2 and 5 years were: carcinoma 50% (+/-11% standard error) and 35% (+/- 12%), sarcoma 59% (+/- 10%) and 51% (+/-12%), teratoma 89% (+/- 5%) and 84% (+/- 7%) respectively. No patientfollowing resection for metastatic melanoma was alive at 2 years. Thesurvival in the teratoma group was significantly higher than in the othergroups (P less than 0.001 carcinoma; P less than 0.01 sarcoma; P less than0.001 melanoma). Survival in all groups was significantly greater than forthe melanoma group. Metastasectomy is well tolerated by the patient.Worthwhile longterm survival is obtained in those patients in whom theprimary disease has been controlled and all secondary disease isencompassed by the proposed surgery.