Survival after pulmonary metastasectomy in soft tissue sarcoma: Prognostic factors in 214 patients

Abstract

This retrospective study examines prognostic factors for post-metastasectomy survival in soft tissue sarcoma patients. Between 1976 and 1992, 274 consecutive patients (median age 49 [7-96] years) with pulmonary metastatic soft tissue sarcoma of the extremity or trunk wall (31 at presentation) were managed at the Mayo Clinic. 21 4 underwent pulmonary metastasectomy and 163 of these also received adjuvant chemotherapy. There were 195 local excisions, 14 lobectomies, and 5 pneumonectomies. 90 patients had solitary metastases, 184 patients had 2 or more metastases. 31 YO of patients had MFH tumors and 88% of all tumors were high grade. Median follow-up for survivors was 8 (2-21) years. 5-year overall survival after metastasectomy was =40% (cf. 20% for non-metastasectomy). Age > 50, MFH tumors, ≥ 2 metastases, metastasis size > 2 cm, metastasis-free period ≤18 months, and the use of adjuvant chemotherapy were univariately unfavorable factors. Size of metastasis > 2 cm, number of metastases ≥2, and metastasis-free interval ≤ 18 months were independently unfavorable for survival. In a prognostic system, patients with 0 risk factors had a 60% 5-year survival, those with 1, 2, or 3 of these factors had 30%, 20% and 0% survival, respectively.