Benefit of surgical treatment of lung metastasis in soft tissue sarcoma
Benefit of surgical treatment of lung metastasis in soft tissue sarcoma
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DOI：
10.1001/archsurg.142.1.70
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发表时间：
2007-01-01
影响因子：
--
通讯作者：
Peiper, Matthias
中科院分区：
文献类型：
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作者：
Rehders, Alexander;Hosch, Stefan B.;Peiper, Matthias
假设：肺转移性软组织肉瘤患者受益于切除术，并可能长期治愈。设计：回顾性医疗记录审查。地点：学术三级护理中心。患者：1991年1月1日至2002年12月31日期间，61名患者（33名男性和28名女性;初次诊断时的中位年龄为42岁[年龄范围为18-74岁]）在德国汉堡-埃彭多夫的大学医院接受了软组织肉瘤肺转移的手术治疗。胸骨切开术或前外侧胸廓切开术进行乳腺切除术，包括楔形切除术或肺叶切除术。主要结果测量：临床和病理因素对疾病特异性生存率的影响进行了分析，使用对数秩检验和多变量考克斯比例风险model.Results：原发肿瘤大小为PT 1的13例患者和PT 2的48例患者。高分化7例，中等分化19例，低分化35例。切除的肺转移灶平均为5个（范围，1-48）。前外侧开胸39例，胸骨切开22例。没有需要手术翻修的严重术后并发症。围手术期死亡率为0%。平均随访60个月，膀胱切除术后的平均生存时间为33个月（范围，2-125个月）。5年生存率为25%。肺转移灶切除的数量与预后无关（P= 0.37）。结论：软组织肉瘤肺转移患者手术切除有益。这种治疗具有低并发症发生率，并对疾病的进程有有利的影响。即使切除复发性肺病，长期生存也是可能的。
Hypothesis: Patients with pulmonary metastatic soft tissue sarcoma benefit from resection, with long-term cure possible.Design: Retrospective medical records review.Setting: Academic tertiary care center.Patients: Between January 1, 1991, and December 31, 2002, 61 patients (33 men and 28 women; median age at initial diagnosis, 42 years [age range, 18-74 years]) were surgically treated for pulmonary metastases of soft tissue sarcoma at University Hospital, Hamburg-Eppendorf, Germany.Interventions: Sternotomy or anterior lateral thoracotomy was performed for metastasectomy, including wedge resection or lobectomy.Main Outcome Measure: The effects of clinical and pathologic factors on disease-specific survival were analyzed using the log rank test and a multivariate Cox proportional hazards model.Results: Primary tumor size was pT1 in 13 patients and pT2 in 48 patients. The differentiation was high in 7 patients, intermediate in 19 patients, and low in 35 patients. The mean number of resected pulmonary metastatic lesions was 5 (range, 1-48). An anterolateral thoracotomy was performed in 39 patients, and sternotomy in 22 patients. There were no significant postoperative complications that required surgical revision. The perioperative mortality was 0%. At a mean follow-up of 60 months, the mean survival time after metastasectomy was 33 months (range, 2-125 months). The 5-year survival was 25%. The number of resected lung metastatic lesions had no prognostic relevance (P=.37).Conclusions: Patients with lung metastasis from soft tissue sarcomas benefit from surgical excision. This treatment has low complication rates and has a favorable influence on the course of the disease. Long-term survival is possible even when recurrent pulmonary disease is resected.