title: Outcomes and clinical predictors of improved survival in a patients undergoing pulmonary metastasectomy for sarcoma.
abstract: BACKGROUND
  Pulmonary metastasectomy (PM) for metastatic sarcoma can result in long-term survival. The purpose of this study was to describe factors associated with survival in a series of patients undergoing PM for metastatic sarcoma.
  
  
  METHODS
  We reviewed all patients undergoing PM for metastatic sarcoma over a 12-year period (2000-2012). Multivariate analyses were used to identify factors associated with outcomes. Survival was calculated with Kaplan-Meier and Cox proportional hazard models.
  
  
  RESULTS
  A total of 120 patients underwent PM with a median follow-up was 48 months. Among 81 (85%) patients who presented with local disease, the median disease free interval (DFI) was 13 months and median overall survival (OS) was 48 months. Fourteen patients (15%) had synchronous metastasis with a median OS of 21 months. On multivariate analysis, synchronous metastasis (P = 0.005), older age (P = 0.02), and number of lung lesions (P = 0.003) were associated with poor survival. The median OS of patients with a DFI ≥12 versus <12 months following primary resection was 93 and 43 months (P = 0.004).
  
  
  CONCLUSIONS
  While patients with a DFI >12 months have the best OS following PM, patients with a DFI <12 months also have excellent outcomes as compared to systemic therapy and should be considered for PM.
authors.affiliation: Moffitt Cancer Center, Tampa, Florida.
authors.forename: Lesly A
authors.initials: LA
authors.lastname: Dossett
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Toloza
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Jacques
authors.initials: J
authors.lastname: Fontaine
authors.affiliation: Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Lary A
authors.initials: LA
authors.lastname: Robinson
authors.affiliation: Sarcoma Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Damon
authors.initials: D
authors.lastname: Reed
authors.affiliation: Sarcoma Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Druta
authors.affiliation: Sarcoma Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Letson
authors.affiliation: Sarcoma Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
authors.affiliation: Sarcoma Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008297:Male; D059146:Metastasectomy / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate
keywords: bone; outcomes; pulmonary metastasectomy; sarcoma; soft tissue