Pulmonary metastasectomy for sarcoma of gynaecologic origin

Pulmonary metastases are relatively common after definitive treatment for sarcoma of soft tissue and bone. Minimal data exists on outcomes following pulmonary metastasectomy for sarcoma of gynaecologic origin (SOGO). A retrospective study was performed to compare overall outcomes of pulmonary metastasectomy for SOGO.

Patients selected had control of their primary tumour, no extra-thoracic disease and were declared fit for surgery. The primary aim was to determine long-term outcomes following pulmonary metastasectomies in patients with sarcoma of gynaecological origin. The International Registry of Lung Metastases (IRLM) staging system, resection status and surgical approach were documented.

Of 101 patients who underwent sarcoma pulmonary metastasectomy between the 2001 and 2011, 13 patients had SOGO (12 leiomyosarcoma). The median age for those undergoing resection for SOGO was 58.2 years. Four patients required iterative metastasectomy. Median OS for SOGO was 76.4 months (95% CI: 11.8-141.0). The three- and five-year survival for sarcoma of gynaecologic origin was 76% and 66% respectively. For all sarcoma cases, minimally invasive surgery was shown to confer a significant survival benefit; five-year OS was 67% compared to 38% for open surgery (p=0.04).

Outcomes after pulmonary metastasectomy for SOGO are favourable compared to other sarcoma resection. IRLM staging was a good predictor of patient outcome. Minimally invasive surgery may have oncologically equivalent outcomes compared to open surgery.