Benefit of surgical treatment of lung metastasis in soft tissue sarcoma.
OBJECTIVE
Patients with pulmonary metastatic soft tissue sarcoma benefit from resection, with long-term cure possible.


METHODS
Retrospective medical records review.


METHODS
Academic tertiary care center.


METHODS
Between January 1, 1991, and December 31, 2002, 61 patients (33 men and 28 women; median age at initial diagnosis, 42 years [age range, 18-74 years]) were surgically treated for pulmonary metastases of soft tissue sarcoma at University Hospital, Hamburg-Eppendorf, Germany.


METHODS
Sternotomy or anterior lateral thoracotomy was performed for metastasectomy, including wedge resection or lobectomy.


METHODS
The effects of clinical and pathologic factors on disease-specific survival were analyzed using the log rank test and a multivariate Cox proportional hazards model.


RESULTS
Primary tumor size was pT1 in 13 patients and pT2 in 48 patients. The differentiation was high in 7 patients, intermediate in 19 patients, and low in 35 patients. The mean number of resected pulmonary metastatic lesions was 5 (range, 1-48). An anterolateral thoracotomy was performed in 39 patients, and sternotomy in 22 patients. There were no significant postoperative complications that required surgical revision. The perioperative mortality was 0%. At a mean follow-up of 60 months, the mean survival time after metastasectomy was 33 months (range, 2-125 months). The 5-year survival was 25%. The number of resected lung metastatic lesions had no prognostic relevance (P = .37).


CONCLUSIONS
Patients with lung metastasis from soft tissue sarcomas benefit from surgical excision. This treatment has low complication rates and has a favorable influence on the course of the disease. Long-term survival is possible even when recurrent pulmonary disease is resected.
Rehders
Alexander
A
Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Düsseldorf, Heinrich-Heine Universität, Moorenstrasse 5, D-40225 Düsseldorf, Germany. rehders@med.uni-duesseldorf.de
Hosch
Stefan B
SB
Scheunemann
Peter
P
Stoecklein
Nikolas H
NH
Knoefel
Wolfram T
WT
Peiper
Matthias
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D051642:Histiocytoma / Q000556:secondary / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D013249:Sternum / Q000601:surgery; D016019:Survival Analysis; D013908:Thoracotomy