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Pulmonary metastasectomy with therapeutic intent for soft-tissue sarcoma
Neel P Chudgar1, Murray F Brennan1, Rodrigo R Munhoz2
1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
The Journal of Thoracic and Cardiovascular Surgery
|April 12, 2017
Summary
Factors like leiomyosarcoma subtype, smaller primary tumors, longer disease-free intervals, and solitary lung metastases improve survival in soft-tissue sarcoma patients undergoing pulmonary metastasectomy.
Area of Science:
- Oncology
- Surgical Oncology
- Thoracic Surgery
Background:
- Soft-tissue sarcoma is a complex cancer with frequent lung metastasis.
- Pulmonary metastasectomy is a potential treatment for these patients.
Purpose of the Study:
- To identify factors influencing survival in soft-tissue sarcoma patients undergoing pulmonary metastasectomy.
- To guide patient selection for this surgical procedure.
Main Methods:
- Analysis of a prospectively maintained database of 539 patients with metastatic soft-tissue sarcoma.
- Inclusion of 760 therapeutic-intent pulmonary metastasectomies performed between 1991 and 2014.
- Utilized Kaplan-Meier, log-rank tests, and Cox proportional hazards models for survival and recurrence analysis.
Main Results:
- Median overall survival was 33.2 months; median disease-free survival was 6.8 months.
- Favorable factors for survival included leiomyosarcoma subtype, primary tumor size ≤10 cm, longer time to metastasis, solitary lung metastasis, and minimally invasive resection.
- Favorable factors for disease recurrence included a disease-free interval ≥1 year and a single pulmonary metastasis.
Conclusions:
- Histologic subtype, primary tumor characteristics, disease-free interval, and metastasis number impact survival in soft-tissue sarcoma patients.
- Minimally invasive resection and specific patient factors are associated with improved outcomes after pulmonary metastasectomy.