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Development and treatment of pulmonary metastases in adult patients with extremity soft tissue sarcoma Gadd MA; Casper ES; Woodruff JM; McCormack PM; Brennan MFAnn Surg 1993[Dec]; 218 (6): 705-12OBJECTIVE: 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.|*Extremities[MESH]|*Pneumonectomy[MESH]|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Incidence[MESH]|Lung Neoplasms/epidemiology/*secondary/*surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Recurrence, Local/epidemiology[MESH]|Prospective Studies[MESH]|Sarcoma/epidemiology/*secondary/*surgery[MESH]|Soft Tissue Neoplasms/*pathology[MESH]|Survival Rate[MESH] |
