Prognostic Factors For Longterm Survival After Pulmonary Metastasectomy

Prognostic Factors For Long-term Survival After Pulmonary Metastasectomy In Sarcoma Patients: A 12 year experience Simon Jordan 1, Peter Goldstraw 1, Elizabeth Belcher 1, Ambrus Szántó 1, Jeremy Whelan 2, Beatrice Seddon 2, Maria Michelagnoli 2, Anna Cassoni 2, Sandra Strauss 2, Michelle Scurr 3, Frank Saran 3, Ian Judson 3, George Ladas 1 Brompton Hospital, London, United Kingdom; College Hospital, London, United Kingdom; 3 Royal Marsden Hospital, London, United Kingdom 1 Royal 2 University Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Background § Pulmonary metastasectomy is an established treatment modality in selected patients § Often the lung is the only site of recurrence § Prognostic factors associated with individual cell types have not been intensively studied Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Aims § To evaluate the long-term survival of patients undergoing pulmonary metastasectomy for sarcoma § To identify factors affecting outcome § To investigate the prognostic significance of preoperative pleural effusion Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Methods § A retrospective review of patients who underwent surgery by between 1995 and 2007 § We examined the impact of age, gender, sarcoma type, disease-free interval (DFI), number and distribution of metastases, prior metastasectomy and the presence of a pleural effusion on survival § Actuarial survival was estimated using Kaplan-Meier methods and comparisons by Cox regression Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Patients demographics Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Overall survival Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Survival according to DFI Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Survival according to repeat metastasectomy Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Multivariate Analysis Univariate Analysis Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Survival according to sarcoma subtype Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Survival according to Number of Metastases Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma

Conclusions § Resection of sarcomatous pulmonary metastases confers good long-term survival, with low operative mortality § Patients with a DFI of 12 months or longer have a significantly better prognosis § Repeat metastasectomy in selected patients is associated with a good prognosis § The presence of a pleural effusion is not a negative prognostic factor and therefore should not preclude surgery Royal Brompton Hospital Pulmonary Metastasectomy for Sarcoma