Survival following Pulmonary Metastasectomy for Sarcoma

Lawrence Okiror, Aikaterini Peleki, Daniel Moffat, Andrea Bille, Ehab Bishay, Pala Rajesh, Richard Steyn, Babu Naidu, Robert Grimer, Maninder Kalkat

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: The aim of this study is to report the overall survival after pulmonary metastasectomy in patients with metastatic sarcoma and prognostic factors for survival.

METHODS: This 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.

RESULTS: Between 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).

CONCLUSION: In selected patients, pulmonary metastasectomy for sarcoma is safe and may confer a good medium-term survival. Recurrent metastasis after resection confers a poor prognosis.

Original languageEnglish
Pages (from-to)146-9
Number of pages4
JournalThoracic and Cardiovascular Surgeon
Volume64
Issue number2
DOIs
Publication statusPublished - Mar 2016

Keywords

  • Adolescent
  • Adult
  • Aged
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms
  • Male
  • Metastasectomy
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local
  • Pneumonectomy
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Sarcoma
  • Thoracic Surgery, Video-Assisted
  • Time Factors
  • Treatment Outcome
  • Young Adult
  • Journal Article
  • Observational Study

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