Results of surgical treatment of pulmonary metastases from soft tissue sarcomas

Abstract

Background The surgical removal of pulmonary metastases forms part of an interdisciplinary oncological treatment concept. Methods Between January 1, 1972 and December 31, 1990, 757 operations were performed in 657 patients and retrospectively analyzed. Results The pulmonary metastases resected were from a carcinoma in 475 patients (72%), and from a sarcoma in 182 patients (28%), 90 of whom (14%) had a soft tissue sarcoma. Irrespective of the primary tumor, the 30-day mortality was 2.2% for the whole group of patients and for the soft tissue sarcoma group alone. The 5-year survival rate for the whole group of 657 patients was 30%, while that of the patients treated for metastases from a soft tissue sarcoma was 21% (median survival 457 days), this was significantly improved after surgery which was carried out with the objective of cure (5-year survival 26%, median survival 676 days). In patients with a disease-free interval of more than 3 years (5-year survival rate 28%, median survival 743 days) the prognosis was better, but the differences were not statistically significant. With respect to sex, primary tumor, number of metastases, side effect, resection technique and adjuvant radiation and/or chemotherapy of the pulmonary metastases, there were no differences in prognosis. Conclusions Even for smaller, homogeneous groups of patients, it was necessary to determine prognostic factors, regardless of the location and histology of the primary site, since this makes it possible to optimize therapeutic indications and management.