Pulmonary metastasectomy and repeat metastasectomy for soft-tissue sarcoma

Abstract

For patients with lung metastases from soft-tissue sarcoma, pulmonary metastasectomy is considered to be the only chance of possible cure. In this survey, we analyzed some potential prognostic factors affecting the outcome in these patients. 34 patients who underwent pulmonary metastasectomy for soft-tissue sarcoma from April 1996 to April 2007, were enrolled in our study. The median follow-up period was 26 months. Survival curves, factors affecting the outcome, and treatment success rate were evaluated. Complete resection was achieved in 88.2% of patients. There was no perioperative mortality. The median overall survival and median disease-free survival were 42 and 27 months, respectively. Incomplete resection and bilateral lung metastases had significant adverse effects on overall survival. Shorter disease-free interval (<18 months) was a significant predictor of survival on multivariate analysis. Metastasectomy was attempted in 12 cases of whom 50% remained disease-free to the end of follow-up. Complete resection is the most important defining factor of success rate and survival. Patients with bilateral lung metastases or a shorter disease-free interval have significantly lower success rates. Repeat metastasectomy is curative in many patients.