Katherine Giuliano1, Teviah Sachs2, Elizabeth Montgomery3, Angela Guzzetta4, Malcolm Brock5, Timothy M Pawlik5, Stephen C Yang5, Nita Ahuja5. 1. School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States. 2. Department of Surgery, Boston University, Boston, Massachusetts, United States. 3. Department of Pathology, Johns Hopkins University, Baltimore, Maryland, United States. 4. Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States. 5. Department of Surgery, Johns Hopkins University, Baltimore, Maryland, United States.
Abstract
BACKGROUND: The most common site of metastasis for soft tissue sarcomas (STSs) is the lung. In patients who are candidates for resection, metastasectomy improves survival. Debate remains, however, on approach and patient selection for surgery. METHODS: We retrospectively analyzed demographics, tumor characteristics, peri- and postoperative factors for 53 patients who underwent lung metastasectomy for STS from 1989 to 2013. Disease-free intervals (DFIs) and survival were determined. Kaplan-Meier estimates and log-rank test were used for comparison and survival analyses. RESULTS: Median overall survival (diagnosis to death or last visit) was 59.9 months (IQR: 118.5), with mean follow-up of 85.3 months (SD: 69.5). Post-lung metastasectomy survival was 82.9%, 52.2%, 28.3%, and 13.3% at 1, 3, 5, and 10 years, respectively. Age at diagnosis of less than 50 years (p = 0.037), a low pathologic grade (p = 0.040), and a DFI until metastasis of greater than 13.5 months (p = 0.007) were significant predictors of improved survival. CONCLUSION: Patients diagnosed at a younger age with low-grade tumors and those with a longer DFI prior to metastasis diagnosis gain the greatest survival advantage with surgery. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: The most common site of metastasis for soft tissue sarcomas (STSs) is the lung. In patients who are candidates for resection, metastasectomy improves survival. Debate remains, however, on approach and patient selection for surgery. METHODS: We retrospectively analyzed demographics, tumor characteristics, peri- and postoperative factors for 53 patients who underwent lung metastasectomy for STS from 1989 to 2013. Disease-free intervals (DFIs) and survival were determined. Kaplan-Meier estimates and log-rank test were used for comparison and survival analyses. RESULTS: Median overall survival (diagnosis to death or last visit) was 59.9 months (IQR: 118.5), with mean follow-up of 85.3 months (SD: 69.5). Post-lung metastasectomy survival was 82.9%, 52.2%, 28.3%, and 13.3% at 1, 3, 5, and 10 years, respectively. Age at diagnosis of less than 50 years (p = 0.037), a low pathologic grade (p = 0.040), and a DFI until metastasis of greater than 13.5 months (p = 0.007) were significant predictors of improved survival. CONCLUSION:Patients diagnosed at a younger age with low-grade tumors and those with a longer DFI prior to metastasis diagnosis gain the greatest survival advantage with surgery. Georg Thieme Verlag KG Stuttgart · New York.