Surgical treatment of pulmonary artery sarcoma

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The study objectives were to characterize the prognostic perspectives of pulmonary artery sarcoma and to investigate the effect of distal embolectomy on the prognosis of surgical treatment of pulmonary artery sarcoma. Nine patients with pulmonary artery sarcoma were surgically treated at Anzhen Hospital, and the data were retrospectively reviewed. Five patients underwent only pulmonary artery sarcoma resection, and 4 patients underwent both pulmonary artery sarcoma resection and distal embolectomy. There was no in-hospital mortality. Four patients had lung ischemia-reperfusion injury, 3 of whom recovered with the support of extended ventilation and positive end-expiratory pressure, and 1 of whom recovered with extracorporeal membrane oxygenation support. During the follow-up, 5 patients who did not undergo distal embolectomy died 6 to 29 months after the procedure, with a median survival time of 10 months. Of the 4 patients undergoing distal embolectomy, 3 died 30, 37, and 43 months after the procedure, and 1 is still alive 39 months after the procedure. All 8 deaths were due to local or systemic recurrence. The patients who underwent distal embolectomy lived longer than the patients who did not undergo distal embolectomy (log-rank test, x(2)=7.914, P=.005). Radical surgical resection provides the only chance of survival for patients with pulmonary artery sarcoma, and distal embolectomy may further extend survival for these patients.