SURGICAL-TREATMENT OF LUNG METASTASES - THE EUROPEAN ORGANIZATION FORRESEARCH AND TREATMENT OF CANCER-SOFT TISSUE AND BONE SARCOMA GROUP-STUDY OF 255 PATIENTS

BACKGROUND. Several reports have shown a prolonged survival after surg ical treatment of pulmonary metastases from soft tissue sarcomas. Howe ver, it is still unclear which prognostic factors predict a favorable outcome. Series are not comparable and the data are conflicting. There fore, a multi-institutional study was undertaken to analyze prognostic factors in selecting patients for resection of pulmonary metastases f rom soft tissue sarcomas. METHODS. This report is a retrospective stud y of the European Organization for Research and Treatment of Cancer-So ft Tissue and Bone Sarcoma Group. Two hundred fifty-five patients unde rwent complete resection of lung metastases from soft tissue sarcomas. Cases with chondrosarcoma and small round cell sarcomas like Ewing sa rcoma were excluded. RESULTS. The 3 year and 5 year overall postmetast asectomy survival rates were 54% and 38%, respectively. The disease fr ee postmetastasectomy survival rates were 42% and 35%, respectively. A nalysis of prognostic factors for a more favorable outcome revealed di sease free intervals of 2.5 years or more, following a resection with microscopically free margins, age less than 40 years, and Grade I and II tumors. These prognostic factors have an independent influence on o verall survival, using a multivariate Cox regression model. CONCLUSION S. Surgical excision of lung metastases from soft tissue sarcomas is w ell accepted and should be considered as a first line of treatment if preoperative evaluation indicates that complete clearance of the metas tases is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy. (C) 1996 American Cancer So ciety.