Resection of recurrent pulmonary metastases in patients with soft-tissue sarcomas
W. E. Rizzoni, H. I. Pass, M. N. Wesley, S. A. Rosenberg and J. A. Roth
Survival benefit and prognostic factors useful for patient selection have
not been previously analyzed for patients with recurrent pulmonary
metastases from soft-tissue sarcomas. Twenty-nine patients in our study had
two or more resections of pulmonary metastases from 1976 to 1983. There
were no operative deaths and three complications for 40 operations (7.5%).
Factors predictive of increased survival following the second resection of
pulmonary metastases were resectability and a disease-free interval of
greater than six months from the first thoracotomy to the second recurrence
in the lung. The tumor doubling time of the first recurrence and the
presence of three or fewer nodules on full-lung tomography before the first
thoracotomy, which were predictors of survival following initial resection,
also predicted survival following subsequent resections. Overall median
survival following the second resection was 14.5 months (22% overall
three-year survival). The postresection actuarial survival curves for
patients undergoing 1, 2, or 3 or more resections were not significantly
different. Our findings demonstrate that patients undergoing repeated
resections of pulmonary metastases from soft-tissue sarcomas can achieve
prolonged survival.
