• Thorac Cardiovasc Surg · Mar 2016

    Observational Study

    Survival following Pulmonary Metastasectomy for Sarcoma.

    • Lawrence Okiror, Aikaterini Peleki, Daniel Moffat, Andrea Bille, Ehab Bishay, Pala Rajesh, Richard Steyn, Babu Naidu, Robert Grimer, and Maninder Kalkat.
    • Department of Thoracic Surgery, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
    • Thorac Cardiovasc Surg. 2016 Mar 1; 64 (2): 146-9.

    ObjectivesThe aim of this study is to report the overall survival after pulmonary metastasectomy in patients with metastatic sarcoma and prognostic factors for survival.MethodsThis is a retrospective observational study of consecutive patients having pulmonary metastasectomy for sarcoma over a 5-year period. Survival was calculated by Kaplan-Meier method.ResultsBetween August 2007 and January 2014, a total of 80 pulmonary metastasectomies were performed on 66 patients with metastatic sarcoma. There were no postoperative in-hospital deaths. The median age was 51 years (range, 16-79) and 39 (59%) patients were male. Fourteen patients had bilateral lung operations and surgical access was by video-assisted thoracoscopic surgery in 48 (73%) cases. The median number of metastases resected was 3 (range, 1-9). The median disease-free interval was 25 months (range, 0-156). Median overall survival was 25.5 months (range, 1-60). At follow-up, 19 patients (29%) were dead with a median follow-up of 31 months (range, 1-60). Recurrence of metastases significantly affected survival: median of 25.5 months (95% confidence interval [CI], 17.7-33.4) versus 48.4 months (95% CI, 42.5-54.4) in patients with no recurrent metastases (p = 0.004). There was no significant difference in survival between patients with high-grade versus low-grade tumors (p = 0.13), histological type (osteosarcoma vs. other soft tissue sarcoma types, p = 0.14), unilateral versus bilateral lung metastases (p = 0.48), or lung metastases alone versus lung and other sites of metastases (p = 0.5).ConclusionIn selected patients, pulmonary metastasectomy for sarcoma is safe and may confer a good medium-term survival. Recurrent metastasis after resection confers a poor prognosis.Georg Thieme Verlag KG Stuttgart · New York.

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