Abstract
Background: Metastatic sarcoma patients have a poor prognosis with 3-year survival rate of 25%. About 30% of them present isolated lung metastases. We aimed to analyze the clinical outcome of sarcoma patients undergoing pulmonary metastasectomy (PM) and prognostic factors associated with local control, disease-free, and overall survival (OS). Patients and Methods: All sarcoma patients undergoing PM at Humanitas Cancer Center were retrospectively reviewed. Analyzed variables included clinicopathologic, surgical, and survival data. Exclusion criterion comprised a follow-up period inferior to 1 year. A univariable and multivariable Cox regression analysis was performed (P<0.05). Results: In total, 154 patients underwent PM from 1997 to 2015. Total complication rate was 7.1%. The median follow-up was 24 months. The median OS was 35.4 months from initial metastasectomy. In univariable analysis, we identified as significant negative prognostic factors a disease-free interval of <18 months, male sex, grading G3, and bilateral metastases. Three histology risk groups were defined according to OS: high risk (myxofibrosarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma), intermediate risk (leiomyosarcoma, liposarcoma, and undifferentiated pleomorphic sarcoma), and low risk (synovial and chondrosarcoma) with a 3-year OS of 21.4%, 45.7%, and 74.1%, respectively. In multivariable analysis, male sex (P=0.042), bilateral metastases (P=0.004), and histology (intermediate vs. low-risk group, P=0.021; high vs. low-risk group, P<0.001) were identified as independent predictors of survival. Conclusions: PM for sarcoma is a valid therapeutic option. High-risk histologies and bilaterality of lung metastases are independent negative prognostic factors. A prognostic score to improve patient selection is proposed.
| Original language | English |
|---|---|
| Journal | American Journal of Clinical Oncology: Cancer Clinical Trials |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- bone sarcoma
- lung metastasis
- prognosis
- pulmonary metastasectomy
- soft tissue sarcoma
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Survival Outcome and Prognostic Factors after Pulmonary Metastasectomy in Sarcoma Patients : A 18-Year Experience at a Single High-volume Referral Center. / Cariboni, Umberto; De Sanctis, Rita; Giaretta, Marta; Voulaz, Emanuele; Morenghi, Emanuela; Colombo, Piergiuseppe; Novellis, Pierluigi; Bottoni, Edoardo; Errico, Valentina; Crepaldi, Alessandro; Marrari, Andrea; Navarria, Pierina; Ascolese, Anna M.; Testori, Alberto; Scorsetti, Marta; Quagliuolo, Vittorio; Santoro, Armando; Alloisio, Marco.
In: American Journal of Clinical Oncology: Cancer Clinical Trials, 01.01.2018.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Survival Outcome and Prognostic Factors after Pulmonary Metastasectomy in Sarcoma Patients
T2 - A 18-Year Experience at a Single High-volume Referral Center
AU - Cariboni, Umberto
AU - De Sanctis, Rita
AU - Giaretta, Marta
AU - Voulaz, Emanuele
AU - Morenghi, Emanuela
AU - Colombo, Piergiuseppe
AU - Novellis, Pierluigi
AU - Bottoni, Edoardo
AU - Errico, Valentina
AU - Crepaldi, Alessandro
AU - Marrari, Andrea
AU - Navarria, Pierina
AU - Ascolese, Anna M.
AU - Testori, Alberto
AU - Scorsetti, Marta
AU - Quagliuolo, Vittorio
AU - Santoro, Armando
AU - Alloisio, Marco
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Metastatic sarcoma patients have a poor prognosis with 3-year survival rate of 25%. About 30% of them present isolated lung metastases. We aimed to analyze the clinical outcome of sarcoma patients undergoing pulmonary metastasectomy (PM) and prognostic factors associated with local control, disease-free, and overall survival (OS). Patients and Methods: All sarcoma patients undergoing PM at Humanitas Cancer Center were retrospectively reviewed. Analyzed variables included clinicopathologic, surgical, and survival data. Exclusion criterion comprised a follow-up period inferior to 1 year. A univariable and multivariable Cox regression analysis was performed (P<0.05). Results: In total, 154 patients underwent PM from 1997 to 2015. Total complication rate was 7.1%. The median follow-up was 24 months. The median OS was 35.4 months from initial metastasectomy. In univariable analysis, we identified as significant negative prognostic factors a disease-free interval of <18 months, male sex, grading G3, and bilateral metastases. Three histology risk groups were defined according to OS: high risk (myxofibrosarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma), intermediate risk (leiomyosarcoma, liposarcoma, and undifferentiated pleomorphic sarcoma), and low risk (synovial and chondrosarcoma) with a 3-year OS of 21.4%, 45.7%, and 74.1%, respectively. In multivariable analysis, male sex (P=0.042), bilateral metastases (P=0.004), and histology (intermediate vs. low-risk group, P=0.021; high vs. low-risk group, P<0.001) were identified as independent predictors of survival. Conclusions: PM for sarcoma is a valid therapeutic option. High-risk histologies and bilaterality of lung metastases are independent negative prognostic factors. A prognostic score to improve patient selection is proposed.
AB - Background: Metastatic sarcoma patients have a poor prognosis with 3-year survival rate of 25%. About 30% of them present isolated lung metastases. We aimed to analyze the clinical outcome of sarcoma patients undergoing pulmonary metastasectomy (PM) and prognostic factors associated with local control, disease-free, and overall survival (OS). Patients and Methods: All sarcoma patients undergoing PM at Humanitas Cancer Center were retrospectively reviewed. Analyzed variables included clinicopathologic, surgical, and survival data. Exclusion criterion comprised a follow-up period inferior to 1 year. A univariable and multivariable Cox regression analysis was performed (P<0.05). Results: In total, 154 patients underwent PM from 1997 to 2015. Total complication rate was 7.1%. The median follow-up was 24 months. The median OS was 35.4 months from initial metastasectomy. In univariable analysis, we identified as significant negative prognostic factors a disease-free interval of <18 months, male sex, grading G3, and bilateral metastases. Three histology risk groups were defined according to OS: high risk (myxofibrosarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma), intermediate risk (leiomyosarcoma, liposarcoma, and undifferentiated pleomorphic sarcoma), and low risk (synovial and chondrosarcoma) with a 3-year OS of 21.4%, 45.7%, and 74.1%, respectively. In multivariable analysis, male sex (P=0.042), bilateral metastases (P=0.004), and histology (intermediate vs. low-risk group, P=0.021; high vs. low-risk group, P<0.001) were identified as independent predictors of survival. Conclusions: PM for sarcoma is a valid therapeutic option. High-risk histologies and bilaterality of lung metastases are independent negative prognostic factors. A prognostic score to improve patient selection is proposed.
KW - bone sarcoma
KW - lung metastasis
KW - prognosis
KW - pulmonary metastasectomy
KW - soft tissue sarcoma
UR - http://www.scopus.com/inward/record.url?scp=85052717536&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052717536&partnerID=8YFLogxK
U2 - 10.1097/COC.0000000000000476
DO - 10.1097/COC.0000000000000476
M3 - Article
C2 - 30048248
AN - SCOPUS:85052717536
JO - American Journal of Clinical Oncology
JF - American Journal of Clinical Oncology
SN - 0277-3732
ER -