title: Pulmonary metastasectomy for soft tissue sarcoma--report from a dual institution experience at the Medical University of Vienna.
abstract: BACKGROUND
  Pulmonary metastasectomy when possible has become therapeutic standard in soft tissue sarcoma patients. However, published reports frequently describe mixed series of patients with bone or soft tissue sarcoma. We report the outcome of 46 soft tissue sarcoma (STS) patients who underwent pulmonary metastasectomy (PM).
  
  
  METHODS
  This current analysis includes retrospective survival data from 46 consecutive STS patients with pulmonary metastases who underwent PM at the Medical University of Vienna between January 2003 and December 2013.
  
  
  RESULTS
  In total 72 pulmonary metastasectomies were performed. 322 metastatic nodules were resected with a median number of four nodules per intervention and the R0 resection rate was 97.2%. The postoperative complication rate as documented was low. Median follow-up (mFU) was 31.8 months (range 3.7-127.4). Median overall survival as calculated from first detection of metastatic disease was 47.1 months (95% confidence interval (CI)=36.2-58.1 months) and 45.3 months (95% CI=33.3-57.4 months) when calculated from first PM until death or last follow-up (n=46). Five-year overall survival calculated from primary diagnosis was 62% and 32% when estimated from first PM. Previous disease free interval (DFI) as calculated from date of surgery of the primary tumour until the date of diagnosis of lung metastasis was 12.2 months (range 0-140.1 months). Median relapse-free survival (mRFS) after first PM to the date of recurrence of lung metastasis, death or last follow-up was 13.4 months (95% CI=3-23.8 months).
  
  
  CONCLUSIONS
  Median overall survival in this selected patient cohort is 45.3 months. Despite the lack of prospective randomised controlled trials, PM is a reasonable treatment strategy in selected patients.
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Internal Medicine I/Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Sarcoma Platform Austria, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Schur
authors.affiliation: Department of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Hoetzenecker
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Internal Medicine I/Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Sarcoma Platform Austria, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Lamm
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Internal Medicine I/Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Sarcoma Platform Austria, Austria.
authors.forename: W J
authors.initials: WJ
authors.lastname: Koestler
authors.affiliation: Department of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Lang
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Amann
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Orthopedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Funovics
authors.affiliation: Department of Orthopedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Nemecek
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Noebauer
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Orthopedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Windhager
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Klepetko
authors.affiliation: Comprehensive Cancer Center - Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Internal Medicine I/Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Sarcoma Platform Austria, Austria. Electronic address: thomas.brodowicz@meduniwien.ac.at.
authors.forename: T
authors.initials: T
authors.lastname: Brodowicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Multimodality treatment; Pulmonary metastasectomy; Soft tissue sarcoma; Survival analysis