Original articleGeneral thoracicPulmonary Resection of Metastatic Sarcoma: Prognostic Factors Associated With Improved Outcomes
Section snippets
Patients and Methods
Ninety-seven patients underwent pulmonary resection for metastatic sarcoma at the Massachusetts General Hospital from June 2002 to December 2008. The study was approved by the Massachusetts General Hospital Institutional Review Board. All patients included in this study demonstrated complete local control of the primary sarcoma and exhibited isolated pulmonary metastases at the time of pulmonary resection. Pulmonary metastases were confirmed pathologically and the histologic features of the
Results
Eighty-nine patients were identified with metastatic sarcoma to the lung with nearly equal male-female distribution (42:47). The mean age for patients at the time of first pulmonary resection was 51 years. A total of 134 pulmonary resections were performed. The histologic type and frequency distribution are illustrated in Figure 1. Osteosarcoma was the most common histologic subtype (19%), followed by malignant fibrous histiocytoma (17%), leiomyosarcoma (15%), and chondrosarcoma (11%). No
Comment
Although the development of metastatic sarcoma in the lung portends a poor prognosis, metastasectomy offers long-term survival for selected patients. Since neither chemotherapy nor radiation has shown effectiveness [11], and in the absence of prospective studies comparing resection to other treatment, many patients are faced with limited options. We retrospectively reviewed our experience with pulmonary metastasectomy in either soft tissue or bone sarcoma. Overall 5-year survival in this highly
References (21)
- et al.
Long-term results of lung metastasectomy: prognostic analyses based on 5206 casesThe International Registry of Lung Metastases
J Thorac Cardiovasc Surg
(1997) - et al.
Analysis of prognostic factors in patients undergoing resection of pulmonary metastases from soft-tissue sarcoma
J Thorac Cardiovasc Surg
(1984) - et al.
Long-term results after repeated surgical removal of pulmonary metastases
Ann Thorac Surg
(1998) - et al.
Resection of pulmonary and extrapulmonary sarcomatous metastases is associated with long-term survival
Ann Thorac Surg
(2009) - et al.
The number of pulmonary metastases influence on practice and outcome
J Thorac Oncol
(2010) - et al.
Radiofrequency ablation for treatment of pulmonary metastases
Ann Thorac Surg
(2009) - et al.
A phase I/II trial of stereotactic body radiation therapy (SBRT) for lung metastases: initial report of dose escalation and early toxicity
Int J Radiat Oncol Biol Phys
(2006) - et al.
Surgical management of pulmonary metastases
Ann Thorac Surg
(2009) - et al.
Comparison of median sternotomy and thoracotomy for resection of pulmonary metastases in patients with adult soft-tissue sarcomas
Ann Thorac Surg
(1986) - et al.
Survival after pulmonary metastasectomy in soft tissue sarcoma
Acta Orthop Scand
(1995)