Benefit of surgical treatment of lung metastasis in soft tissue sarcoma

Arch Surg. 2007 Jan;142(1):70-5; discission 76. doi: 10.1001/archsurg.142.1.70.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Histiocytoma / secondary
  • Histiocytoma / surgery
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Sarcoma / mortality
  • Sarcoma / pathology
  • Sarcoma / secondary*
  • Sternum / surgery
  • Survival Analysis
  • Thoracotomy