RT Journal
A1 Rehders A, Hosch SB, Scheunemann P, Stoecklein NH, Knoefel WT, Peiper M
T1 BEnefit of surgical treatment of lung metastasis in soft tissue sarcoma
JF Archives of Surgery
JO Archives of Surgery
YR 2007
FD January 1
VO 142
IS 1
SP 70
OP 75
DO 10.1001/archsurg.142.1.70
UL http://dx.doi.org/10.1001/archsurg.142.1.70
AB Hypothesis 
    Patients with pulmonary metastatic soft tissue sarcoma benefit from resection, with long-term cure possible.Design 
    Retrospective medical records review.Setting 
    Academic tertiary care center.Patients 
    Between January 1, 1991, and December 31, 2002, 61 patients (33 men and 28 women; median age at initial diagnosis, 42 years [age range, 18-74 years]) were surgically treated for pulmonary metastases of soft tissue sarcoma at University Hospital, Hamburg-Eppendorf, Germany.Interventions 
    Sternotomy or anterior lateral thoracotomy was performed for metastasectomy, including wedge resection or lobectomy.Main Outcome Measure 
    The effects of clinical and pathologic factors on disease-specific survival were analyzed using the log rank test and a multivariate Cox proportional hazards model.Results 
    Primary tumor size was pT1 in 13 patients and pT2 in 48 patients. The differentiation was high in 7 patients, intermediate in 19 patients, and low in 35 patients. The mean number of resected pulmonary metastatic lesions was 5 (range, 1-48). An anterolateral thoracotomy was performed in 39 patients, and sternotomy in 22 patients. There were no significant postoperative complications that required surgical revision. The perioperative mortality was 0%. At a mean follow-up of 60 months, the mean survival time after metastasectomy was 33 months (range, 2-125 months). The 5-year survival was 25%. The number of resected lung metastatic lesions had no prognostic relevance (P = .37).Conclusions 
    Patients with lung metastasis from soft tissue sarcomas benefit from surgical excision. This treatment has low complication rates and has a favorable influence on the course of the disease. Long-term survival is possible even when recurrent pulmonary disease is resected.