Surgical treatment of pulmonary metastases is part of an interdisciplinary strategy in oncological therapy. Between 1973 and 1989, 620 thoracotomies were performed in 549 patients. The most profitable access was the median sternotomy. Thirty-day mortality was 2.7%, 5-year survival was 30% for all patients. If the resection was classified as potentially curative, 5-year survival was 35%. Patients with pulmonary metastases of testicular tumors (5-year-survival rate 70%) had the best prognosis. Prognostic factors must take the primary tumor into consideration.