cancer information

Pulmonary metastatic soft tissue sarcoma curable with surgical excision

Reuters Health Posting Date: January 19, 2007

Last Updated: 2007-01-19 14:13:32 -0400 (Reuters Health) NEW YORK (Reuters Health) - Resection of soft tissue sarcoma metastatic to the lungs can be accomplished with very low morbidity and mortality, surgeons in Germany report, and may in fact be curative. Although pulmonary soft tissue sarcomas (STS) resection is a common procedure, lead author Dr. Alexander Rehders and his associates note in the Archives of Surgery for January, agreement as to which patients make the best candidates has yet to be established. Their current results suggest that "it seems worthwhile to operate on every patient with lung metastasis unless serious comorbidity or technically unresectable metastatic disease is present." At University Hospital in Hamburg-Eppendorf, all patients with operable lung STS metastasis undergo radical surgery with curative intent. The only exceptions are failure of the primary tumor to regress at least partially after 6 months of chemotherapy, extensive involvement of the mediastinum or chest wall, unresectable lung disease or metastatic disease outside the lung, other comorbidities, or insufficient pulmonary function. Between 1991 and 2002, 61 of 121 patients at their institution who developed pulmonary metastasis of STS underwent sternotomy or anterior lateral thoracotomy for metastasectomy, including wedge resection or lobectomy. There were no cases of perioperative mortality. Nine patients experienced transient alveolar leakage requiring pleural drainage, three had wound infections, and three experienced hypoventilation. Otherwise, there were no major complications. After a mean follow-up of 60 months, survival time averaged 33 months (range 2 to 125 months), the authors report. The 5-year survival rate was 25%. None of the common risk factors assessed - age, gender, tumor grade, number of metastatic lesions, bilateral involvement, histologic type, site of primary tumor, and interval before STS metastasis was diagnosed - had any significant effect on survival. Dr. Rehders and his associates report that six patients underwent repeat STS excisions, and that these patients were among the 13 who lived the longest. Arch Surg 2007;142:70-75. Copyright ? 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.