Optimizing surgical management for pulmonary artery sarcoma: A 24-year single-center analysis

Area of Science:

• Cardiovascular Surgery
• Surgical Oncology
• Thoracic Surgery

Background:

• Pulmonary artery sarcoma (PAS) is a rare, aggressive cancer often mistaken for chronic thromboembolic pulmonary hypertension.
• Effective long-term treatment strategies for PAS remain challenging.

Purpose of the Study:

• To evaluate long-term outcomes of surgical treatment for pulmonary artery sarcoma (PAS).
• To compare traditional surgical methods with a novel integrated strategy for PAS management.

Main Methods:

• Retrospective review of 31 patients with PAS who underwent surgery.
• Categorization into traditional resection versus an integrated strategy (imaging-guided planning, en bloc resection, pulmonary endarterectomy, vascular reconstruction).
• Kaplan-Meier survival analysis for 26 patients surviving the perioperative period.

Main Results:

• Median follow-up was 38 months; 13 of 26 patients experienced recurrence.
• 1-, 3-, and 5-year survival rates were 78.1%, 50.5%, and 19.9%, respectively.
• The integrated surgery group showed significantly improved survival (P=.0234) with no early deaths and lower recurrence rates compared to traditional surgery.

Conclusions:

• An integrated surgical approach, including radical resection, pulmonary endarterectomy, and vascular reconstruction, may enhance survival in select PAS patients.
• Early diagnosis and personalized surgical planning are crucial for optimizing long-term outcomes in pulmonary artery sarcoma.