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Thorac Cardiovasc Surg 2016; 64(02): 150-158
DOI: 10.1055/s-0035-1563538
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Survival Following Lung Metastasectomy in Soft Tissue Sarcomas

Katherine Giuliano
1   School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Teviah Sachs
2   Department of Surgery, Boston University, Boston, Massachusetts, United States
,
Elizabeth Montgomery
3   Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States
,
Angela Guzzetta
4   Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States
,
Malcolm Brock
5   Department of Surgery, Johns Hopkins University, Baltimore, Maryland, United States
,
Timothy M. Pawlik
5   Department of Surgery, Johns Hopkins University, Baltimore, Maryland, United States
,
Stephen C. Yang
5   Department of Surgery, Johns Hopkins University, Baltimore, Maryland, United States
,
Nita Ahuja
5   Department of Surgery, Johns Hopkins University, Baltimore, Maryland, United States
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Publikationsverlauf

27. April 2015

25. Juni 2015

Publikationsdatum:
04. September 2015 (online)

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Abstract

Background The most common site of metastasis for soft tissue sarcomas (STSs) is the lung. In patients who are candidates for resection, metastasectomy improves survival. Debate remains, however, on approach and patient selection for surgery.

Methods We retrospectively analyzed demographics, tumor characteristics, peri- and postoperative factors for 53 patients who underwent lung metastasectomy for STS from 1989 to 2013. Disease-free intervals (DFIs) and survival were determined. Kaplan–Meier estimates and log-rank test were used for comparison and survival analyses.

Results Median overall survival (diagnosis to death or last visit) was 59.9 months (IQR: 118.5), with mean follow-up of 85.3 months (SD: 69.5). Post-lung metastasectomy survival was 82.9%, 52.2%, 28.3%, and 13.3% at 1, 3, 5, and 10 years, respectively. Age at diagnosis of less than 50 years (p = 0.037), a low pathologic grade (p = 0.040), and a DFI until metastasis of greater than 13.5 months (p = 0.007) were significant predictors of improved survival.

Conclusion Patients diagnosed at a younger age with low-grade tumors and those with a longer DFI prior to metastasis diagnosis gain the greatest survival advantage with surgery.

Keywords

lung cancer treatment - metastases/metastasectomy - sarcoma - thoracoscopy/VATS