Prognostic Factors of Pulmonary Metastasectomy for Soft Tissue Sarcomas Arising in the Trunk Wall and Extremities

SIMPLE SUMMARY: Pulmonary metastasectomy (PM) is often performed in sarcoma patients with resectable oligo-metastases in the lungs. Although there have been several studies on PM for sarcomas, few have analyzed only soft tissue sarcomas (STSs) arising in the trunk wall and extremities, and many of these studies are older. Therefore, it would be of interest to confirm the outcomes of PM for STS in recent years, when systemic treatment has advanced, in accordance with the latest WHO classification. In the present study, we investigated our recent results of PM for STSs arising in the trunk and extremities, and analyzed the prognostic factors and safety of PM. ABSTRACT: Although there is no evidence from prospective randomized controlled trials to support this practice, pulmonary metastases of sarcomas are often treated surgically if they are resectable. The purpose of this retrospective study was to evaluate the prognostic factors and outcome of pulmonary metastasectomy (PM) for soft tissue sarcomas (STSs) arising in the trunk wall and extremities in 66 consecutive patients. Prognostic factors associated with disease-specific survival after PM were evaluated using univariate and multivariate analyses. The patients included 38 men and 28 women, with a median age of 49 years. The median disease-specific survival after PM was 48 months, and the 5-year survival rate was 45%. No major perioperative complications occurred. Disease-free interval (<12 months), size of largest lung lesion (≥20 mm), and non-curative resection were independent prognostic factors in multivariate analysis. PM was effective in selected patients with pulmonary metastases from STSs arising in the trunk wall and extremities. Disease-free interval, maximum size of metastases, and resectability were identified as prognostic factors.