Factors associated with actual long-term survival following soft tissue sarcoma pulmonary metastasectomy
Factors associated with actual long-term survival following soft tissue sarcoma pulmonary metastasectomy
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DOI：
10.1016/j.ejso.2008.01.004
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发表时间：
2009-04-01
期刊：
影响因子：
3.8
通讯作者：
Kane, J. M., III
中科院分区：
文献类型：
--
作者：
Smith, R.;Pak, Y.;Kane, J. M., III
目的：目的：探讨软组织肉瘤（STS）肺转移患者行肺肿瘤切除术（PM.Methods）后的长期总生存率（OS）与临床病理和治疗变量的关系。收集人口统计学资料，肿瘤的特点，治疗，和outcome.Results：大多数原发性肿瘤中/高级别和常见的组织病理学均匀分布。原发性肿瘤有一半位于四肢。从最初诊断到转移的平均无病期（DFI）为25个月（中位数15个月）。18例患者有同步转移性疾病。双侧肺转移和>1处转移多见。切除的转移瘤的中位数为2.5。34例患者在PM时有肺外肿瘤;所有肺外疾病均被切除。74例患者进行了阴性切缘切除（RO）PM。所有患者的实际5年无病生存率（DFS）和OS分别为5%和15%。对于RO组，实际5年DFS和OS分别为7%和18%。RO切除术，它延长DFI与改善OS。患者的特点，肿瘤的特点，局部复发，和辅助治疗不影响OS。结论：不到20%的STS PM患者将生存5年。完全切除和DF 1是延长生存期的最佳预测因素。(C)2008爱思唯尔有限公司保留所有权利。
Aims: To identify clinicopathologic and treatment variables associated with long-term overall survival (OS) in soft tissue sarcoma (STS) patients with lung metastases undergoing pulmonary metastasectomy (PM).Methods: Retrospective review of 94 STS PM patients with an actual follow-up >= 5 years. Data were collected on demographics, tumor features, treatment, and outcome.Results: Most primary tumors were intermediate/high grade and the common histopathologies were evenly distributed. Half of the primary tumors were located on the extremities. The mean disease-free interval (DFI) from time of original diagnosis until metastases was 25 months (median 15 months). Eighteen patients had synchronous metastatic disease. Bilateral pulmonary metastases and >1 metastasis were common. The median number of metastases resected was 2.5. Thirty-four patients had extrapulmonary tumor at the time of PM; all extrapulmonary disease was resected. Negative margin resection (RO) PM was performed in 74 patients. Actual 5-year disease-free survival (DFS) and OS for all patients were 5% and 15%, respectively. For the RO group, actual 5-year DFS and OS were 7% and 18%, respectively. RO resection and it prolonged DFI were associated with improved OS. Patient characteristics, tumor features, local recurrence, and adjuvant therapy did not affect OS.Conclusions: Less than 20% of STS PM patients will survive 5 years. Complete resection and DF1 are the most predictive factors for prolonged survival. (C) 2008 Elsevier Ltd. All rights reserved.