Development and treatment of pulmonary metastases in adult patients with extremity soft tissue sarcoma Journal Article
| Authors: | Gadd, M. A.; Casper, E. S.; Woodruff, J. M.; McCormack, P. M.; Brennan, M. F. |
| Article Title: | Development and treatment of pulmonary metastases in adult patients with extremity soft tissue sarcoma |
| Abstract: | Objective: The authors reviewed a series of adult patients with extremity soft tissue sarcoma to determine the incidence of pulmonary metastases and outcome after treatment. Methods: Of 716 patients admitted between January 1983 and December 1990, 135 (19%) had isolated pulmonary metastases as the initial site of distant recurrence. Fifty-eight percent (78 of 135) of the patients were treated surgically, and 83% of them had their tumors completely resected. Results: The median survival after complete resection was 19 months; incomplete resection, 10 months; and no operation, 8 months (p = 0.005). The 3-year survival rate after complete resection was 23%, compared with a 2% rate (1 of 57) in those treated nonsurgically (p < 0.001). Factors associated with an increased risk of pulmonary metastases included high tumor grade, tumor size greater than 5 cm, lower extremity site, and histologic type (spindle cell, tendosynovial, and extraskeletal osteosarcoma). Factors associated with complete resectability were the histologic types of spindle cell and extraskeletal osteosarcoma. Conclusions: Complete surgical resection remains the only possibility for cure from pulmonary metastases in soft tissue sarcoma; however, only 11% of the 19% of patients with an extremity sarcoma whose first distant recurrence is in the lung will be alive at 3 years, despite therapy. Complete resection and the development of more effective adjuvant treatments are imperative to improve outcome for this group of patients. |
| Keywords: | adolescent; adult; cancer chemotherapy; cancer survival; aged; aged, 80 and over; survival rate; major clinical study; clinical feature; histopathology; follow-up studies; cancer grading; prospective studies; tumor localization; cancer immunotherapy; neoplasm recurrence, local; tumor volume; lung resection; thoracotomy; lung neoplasms; pneumonectomy; incidence; sarcoma; lung metastasis; tumor recurrence; soft tissue sarcoma; extremities; sternotomy; soft tissue neoplasms; middle age; human; male; female; priority journal; article |
| Journal Title: | Annals of Surgery |
| Volume: | 218 |
| Issue: | 6 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1993-12-01 |
| Start Page: | 705 |
| End Page: | 712 |
| Language: | English |
| DOI: | 10.1097/00000658-199312000-00002 |
| PUBMED: | 8257219 |
| PROVIDER: | scopus |
| PMCID: | PMC1243064 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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