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Survival following Pulmonary Metastasectomy for Sarcoma.

Okiror, Lawrence and Peleki, Aikaterini and Moffat, Daniel and Bille, Andrea and Bishay, Ehab and Rajesh, Pala B and Steyn, Richard and Naidu, Babu V and Grimer, Robert and Kalkat, Maninder S (2015) Survival following Pulmonary Metastasectomy for Sarcoma. The Thoracic and cardiovascular surgeon. ISSN 1439-1902.

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Abstract

Objectives The aim of this study is to report the overall survival after pulmonary metastasectomy in patients with metastatic sarcoma and prognostic factors for survival. Methods This is a retrospective observational study of consecutive patients having pulmonary metastasectomy for sarcoma over a 5-year period. Survival was calculated by Kaplan-Meier method. Results Between August 2007 and January 2014, a total of 80 pulmonary metastasectomies were performed on 66 patients with metastatic sarcoma. There were no postoperative in-hospital deaths. The median age was 51 years (range, 16-79) and 39 (59%) patients were male. Fourteen patients had bilateral lung operations and surgical access was by video-assisted thoracoscopic surgery in 48 (73%) cases. The median number of metastases resected was 3 (range, 1-9). The median disease-free interval was 25 months (range, 0-156). Median overall survival was 25.5 months (range, 1-60). At follow-up, 19 patients (29%) were dead with a median follow-up of 31 months (range, 1-60). Recurrence of metastases significantly affected survival: median of 25.5 months (95% confidence interval [CI], 17.7-33.4) versus 48.4 months (95% CI, 42.5-54.4) in patients with no recurrent metastases (p = 0.004). There was no significant difference in survival between patients with high-grade versus low-grade tumors (p = 0.13), histological type (osteosarcoma vs. other soft tissue sarcoma types, p = 0.14), unilateral versus bilateral lung metastases (p = 0.48), or lung metastases alone versus lung and other sites of metastases (p = 0.5). Conclusion In selected patients, pulmonary metastasectomy for sarcoma is safe and may confer a good medium-term survival. Recurrent metastasis after resection confers a poor prognosis.

Item Type: Article
Subjects: QZ Pathology. Oncology
WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Thoracic Surgery
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Depositing User: Miss Adele Stanton
Date Deposited: 30 May 2015 06:39
Last Modified: 30 May 2015 06:39
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/820

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