PULMONARY METASTASECTOMY FOR SOFT-TISSUE SARCOMAS - IS IT JUSTIFIED

The role of pulmonary metastasectomy for metastatic soft tissue sarcom as is examined by reviewing the recent (1978-1994) English language li terature. There are no prospective studies that contain an appropriate control group, and only one retrospective study contains a matched co ntrol group. In those few studies that provide greater than 5-year sur vival data, the survival curve still has a steep slope and few patient s are alive at 7 years. In most studies only one or two patients are a t risk at 5 years or more. Projected survival is therefore statistical ly questionable. It is currently impossible to know what is the impact of the surgical procedure over and above the natural history (biology ) of the tumor. A randomized, prospective study, as suggested a decade ago, is still needed. While there may be some merit to pulmonary meta stasectomy in highly selected patients, aggressive pulmonary metastase ctomy does not seem justified by the available data. (C) 1995 Wiley-Li ss, Inc.