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Outcomes and clinical predictors of improved survival in a patients undergoing pulmonary metastasectomy for sarcoma
Author(s) -
Dossett Lesly A.,
Toloza Eric M.,
Fontaine Jacques,
Robinson Lary A.,
Reed Damon,
Druta Mihaela,
Letson Douglas G.,
Zager Jonathan S.,
Gonzalez Ricardo J.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23961
Subject(s) - medicine , metastasectomy , proportional hazards model , hazard ratio , sarcoma , multivariate analysis , overall survival , surgery , metastasis , survival analysis , confidence interval , cancer , pathology
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. J. Surg. Oncol. 2015 111:103–106 . © 2015 Wiley Periodicals, Inc.