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Eur J Cancer. 2014 Sep;50(13):2289-97. doi: 10.1016/j.ejca.2014.05.009. Epub 2014 Jul 2.

Pulmonary metastasectomy for soft tissue sarcoma--report from a dual institution experience at the Medical University of Vienna.

Author information

  • 1Comprehensive 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.
  • 2Department of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
  • 3Comprehensive 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.
  • 4Comprehensive 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.
  • 5Department of Orthopedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
  • 6Comprehensive 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.
  • 7Comprehensive 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.
  • 8Comprehensive 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.

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).

CONCLUSION:

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.

KEYWORDS:

Multimodality treatment; Pulmonary metastasectomy; Soft tissue sarcoma; Survival analysis

PMID:
24997493
DOI:
10.1016/j.ejca.2014.05.009
[PubMed - indexed for MEDLINE]
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