Perioperative chemotherapy in patients undergoing pulmonary resection for metastatic soft-tissue sarcoma of the extremity: A retrospective analysis Journal Article

  

Authors:	Canter, R. J.; Qin, L. X.; Downey, R. J.; Brennan, M. F.; Singer, S.; Maki, R. G.
Article Title:	Perioperative chemotherapy in patients undergoing pulmonary resection for metastatic soft-tissue sarcoma of the extremity: A retrospective analysis
Abstract:	BACKGROUND. The benefit of chemotherapy in the treatment of primary soft-tissue sarcoma (STS) is controversial. To the authors' knowledge, few studies to date have examined the effect of chemotherapy in patients undergoing pulmonary resection for metastatic STS of the extremity. METHODS. Between 1990 and 2005, 1897 patients with extremity STS were treated and prospectively followed at a single institution. In all, 508 patients (27%) developed lung metastases as the first site of distant recurrence, and 138 (7%) were treated with pulmonary resection. RESULTS. Perioperative chemotherapy was administered to 53 patients (38%). Age at diagnosis and disease-free interval were significantly different between patients who received perioperative chemotherapy and those who did not, whereas sex, grade, size of the primary tumor, depth, histology, number and size of lung metastases, and rate of complete resection were not. The median post-metastasis disease-specific survival was 24 months in patients who were treated with surgery and chemotherapy compared with 33 months in patients who were treated with surgery alone (P = .19). The median postmetastasis pulmonary progression-free survival in the 2 groups was 10 months and 11 months, respectively (P = .63). Multivariate Cox proportional hazards modeling and propensity score analysis revealed no association between perioperative chemotherapy and disease-specific, overall, or pulmonary progression-free survival. CONCLUSIONS. Although it is difficult to completely control for the effects of selection bias on outcome in this highly selected cohort of patients, data from the current study suggest that systemic chemotherapy has minimal, if any, long-term impact on the outcome of patients undergoing pulmonary resection for metastatic STS of the extremity.
Keywords:	survival; adolescent; adult; cancer chemotherapy; cancer survival; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; retrospective studies; major clinical study; cancer recurrence; doxorubicin; antineoplastic agents; gemcitabine; combined modality therapy; drug megadose; dacarbazine; lung resection; lung neoplasms; ifosfamide; docetaxel; sarcoma; kaplan-meiers estimate; lung metastasis; proportional hazards model; cancer size; soft tissue sarcoma; extremities; flavopiridol; mesna; gender; perioperative chemotherapy; soft tissue neoplasms; perioperative care; soft-tissue sarcoma; long-term impact; pulmonary metastasectomy; pulmonary surgical procedures
Journal Title:	Cancer
Volume:	110
Issue:	9
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	2007-11-01
Start Page:	2050
End Page:	2060
Language:	English
DOI:	10.1002/cncr.23023
PUBMED:	17828771
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-35648941713&partnerID=40&md5=15f9fb6dc5a98ad5eb0536526c2f9eeb
Notes:	--- - "Cited By (since 1996): 8" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus"

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