Outcomes and clinical predictors of improved survival in a patients undergoing pulmonary metastasectomy for sarcoma

J Surg Oncol. 2015 Jul;112(1):103-6. doi: 10.1002/jso.23961. Epub 2015 Jul 14.


Background: Pulmonary metastasectomy (PM) for metastatic sarcoma can result in long-term survival. The purpose of this study was to describe factors associated with survival in a series of patients undergoing PM for metastatic sarcoma.

Methods: We reviewed all patients undergoing PM for metastatic sarcoma over a 12-year period (2000-2012). Multivariate analyses were used to identify factors associated with outcomes. Survival was calculated with Kaplan-Meier and Cox proportional hazard models.

Results: A total of 120 patients underwent PM with a median follow-up was 48 months. Among 81 (85%) patients who presented with local disease, the median disease free interval (DFI) was 13 months and median overall survival (OS) was 48 months. Fourteen patients (15%) had synchronous metastasis with a median OS of 21 months. On multivariate analysis, synchronous metastasis (P = 0.005), older age (P = 0.02), and number of lung lesions (P = 0.003) were associated with poor survival. The median OS of patients with a DFI ≥12 versus <12 months following primary resection was 93 and 43 months (P = 0.004).

Conclusion: While patients with a DFI >12 months have the best OS following PM, patients with a DFI <12 months also have excellent outcomes as compared to systemic therapy and should be considered for PM.

Keywords: bone; outcomes; pulmonary metastasectomy; sarcoma; soft tissue.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery
  • Male
  • Metastasectomy / mortality*
  • Middle Aged
  • Neoplasm Staging
  • Pneumonectomy / mortality*
  • Prognosis
  • Retrospective Studies
  • Sarcoma / mortality*
  • Sarcoma / pathology
  • Sarcoma / surgery
  • Survival Rate