Abstract
Objectives The aim of this study is to report the overall survival after pulmonary metastasectomy in patients with metastatic sarcoma and prognostic factors for survival.
Methods This is a retrospective observational study of consecutive patients having pulmonary metastasectomy for sarcoma over a 5-year period. Survival was calculated by Kaplan–Meier method.
Results Between August 2007 and January 2014, a total of 80 pulmonary metastasectomies were performed on 66 patients with metastatic sarcoma. There were no postoperative in-hospital deaths. The median age was 51 years (range, 16–79) and 39 (59%) patients were male. Fourteen patients had bilateral lung operations and surgical access was by video-assisted thoracoscopic surgery in 48 (73%) cases. The median number of metastases resected was 3 (range, 1–9). The median disease-free interval was 25 months (range, 0–156). Median overall survival was 25.5 months (range, 1–60). At follow-up, 19 patients (29%) were dead with a median follow-up of 31 months (range, 1–60). Recurrence of metastases significantly affected survival: median of 25.5 months (95% confidence interval [CI], 17.7–33.4) versus 48.4 months (95% CI, 42.5–54.4) in patients with no recurrent metastases (p = 0.004). There was no significant difference in survival between patients with high-grade versus low-grade tumors (p = 0.13), histological type (osteosarcoma vs. other soft tissue sarcoma types, p = 0.14), unilateral versus bilateral lung metastases (p = 0.48), or lung metastases alone versus lung and other sites of metastases (p = 0.5).
Conclusion In selected patients, pulmonary metastasectomy for sarcoma is safe and may confer a good medium-term survival. Recurrent metastasis after resection confers a poor prognosis.
Keywords
pulmonary metastasectomy - sarcoma - survival
