title: Factors associated with actual long-term survival following soft tissue sarcoma pulmonary metastasectomy.
abstract: OBJECTIVE
  To identify clinicopathologic and treatment variables associated with long-term overall survival (OS) in soft tissue sarcoma (STS) patients with lung metastases undergoing pulmonary metastasectomy (PM).
  
  
  METHODS
  Retrospective review of 94 STS PM patients with an actual follow-up > or = 5 years. Data were collected on demographics, tumor features, treatment, and outcome.
  
  
  RESULTS
  Most primary tumors were intermediate/high grade and the common histopathologies were evenly distributed. Half of the primary tumors were located on the extremities. The mean disease-free interval (DFI) from time of original diagnosis until metastases was 25 months (median 15 months). Eighteen patients had synchronous metastatic disease. Bilateral pulmonary metastases and >1 metastasis were common. The median number of metastases resected was 2.5. Thirty-four patients had extrapulmonary tumor at the time of PM; all extrapulmonary disease was resected. Negative margin resection (R0) PM was performed in 74 patients. Actual 5-year disease-free survival (DFS) and OS for all patients were 5% and 15%, respectively. For the R0 group, actual 5-year DFS and OS were 7% and 18%, respectively. R0 resection and a prolonged DFI were associated with improved OS. Patient characteristics, tumor features, local recurrence, and adjuvant therapy did not affect OS.
  
  
  CONCLUSIONS
  Less than 20% of STS PM patients will survive 5 years. Complete resection and DFI are the most predictive factors for prolonged survival.
authors.affiliation: Department of Surgical Oncology, Roswell Park Cancer Institute and State University of New York at Buffalo, Buffalo, NY 14263, USA.
authors.forename: R
authors.initials: R
authors.lastname: Smith
authors.forename: Y
authors.initials: Y
authors.lastname: Pak
authors.forename: W
authors.initials: W
authors.lastname: Kraybill
authors.forename: J M
authors.initials: JM
authors.lastname: Kane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018572:Disease-Free Survival; D005121:Extremities / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D055815:Young Adult