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

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.