The benefit of pulmonary metastectomy for bone and soft tissue sarcomas

The outcome of patients having metastectomy for pulmonary metastases from l ocally controlled primary malignancy of bone and soft tissue of the limbs i s compared to a similar group deprived of such therapy. Forty patients rece iving pulmonary metastectomy and 18 patients who were candidates for, but d id not receive, metastectomy were compared by age, sex, histology, number o f metastases, synchronous and metachronous presentation of metastases and t he use of chemotherapy. The only variable correlated with survival was meta stectomy. Surgical mortality was 0%, complications occurred following 11.7% of the procedures, survival of the 40 metastectomised patients (median 60 months) was better than that of the 18 patients not operated upon (median 2 8 months; P = 0.02). For osteosarcoma, median survival was 51 months versus 30 months, respectively (P = 0.004). Median survival for patients undergoi ng pulmonary metastectomy was twice that of those not receiving metastectom y. The number and time of appearance of metastases does not appear to be a deterrent.