Pulmonary metastasectomy for sarcoma-survival and prognostic analysis

Area of Science:

• Oncology
• Thoracic Surgery
• Surgical Oncology

Background:

• Pulmonary metastasectomy (PM) is a common procedure for patients with controlled metastatic sarcoma.
• This study reviews a single-institution experience with pulmonary resections for sarcoma to analyze clinical outcomes and identify prognostic factors.

Purpose of the Study:

• To analyze clinical outcomes of pulmonary metastasectomy for sarcoma.
• To identify prognostic factors associated with patient survival after pulmonary metastasectomy.

Main Methods:

• Retrospective analysis of 33 sarcoma patients undergoing curative intent PM between 2008 and 2014.
• Evaluation of factors including primary tumor characteristics, metastases, therapy, inflammation, and nutritional status using univariable Cox proportional hazard models.
• Receiver operating characteristic (ROC) analysis to determine cut-off values for continuous variables.

Main Results:

• No perioperative deaths; 15.2% major complications. Median follow-up was 37 months, with a 5-year overall survival (OS) rate of 40.4%.
• Complete resection (R0) achieved in 93.9% of patients.
• Shorter interoperative interval (<30 months) and Grade 3 (G3) sarcoma were significant negative prognosticators (HR 5.05 and 3.52, respectively).

Conclusions:

• Pulmonary metastasectomy for sarcomatous disease is a reasonable therapeutic option with acceptable survival in selected patients, despite the lack of randomized controlled trials.
• Shorter survival after PM can be anticipated in sarcoma patients with a shorter interoperative interval and G3 tumors.