The benefit of pulmonary metastectomy for bone and soft tissue sarcomas

The outcome of patients having metastectomy for pulmonary metastases from locally controlled primary malignancy of bone and soft tissue of the limbs is compared to a similar group deprived of such therapy. Forty patients receiving pulmonary metastectomy and 18 patients who were candidates for, but did not receive, metastectomy were compared by age, sex, histology, number of metastases, synchronous and metachronous presentation of metastases and the use of chemotherapy. The only variable correlated with survival was metastectomy. Surgical mortality was 0%, complications occurred following 11.7% of the procedures. Survival of the 40 metastectomised patients (median 60 months) was better than that of the 18 patients not operated upon (median 28 months; P = 0.02). For osteosarcoma, median survival was 51 months versus 30 months, respectively (P = 0.004). Median survival for patients undergoing pulmonary metastectomy was twice that of those not receiving metastectomy. The number and time of appearance of metastases does not appear to be a deterrent.