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Improving survival after pulmonary metastasectomy for sarcoma: analysis of prognostic factors

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Abstract

Background

Metastatic sarcoma confers a grave prognosis to patients and poses a management dilemma for clinicians. Pulmonary metastasectomy is frequently performed for the recurrence of sarcomatous tumours in the lung, but the evidence-base is poor. No guidelines exist to inform clinicians on appropriate patient selection and surgical technique.

Aim

This review aims to establish and analyse the most important prognostic factors for survival post pulmonary metastasectomy for recurrent sarcoma. We summarise the key tumour, peri-operative and patient characteristics that should guide surgical management.

Methods

A comprehensive search of the literature utilising OVID Medline and PubMed databases was conducted to identify all relevant research within the past 15 years. We evaluated all articles that specifically studied sarcoma patients (both bone and soft tissue).

Conclusion

Disease-free interval and tumour burden remain important prognostic factors, while tumour grade is likely not significant. VATS is a safe and viable alternative to thoracotomy without sacrificing survival outcomes. No single peri-operative characteristic provides useful prognostic information in isolation.

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Data Availability

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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  1. Department of Cardiothoracic Surgery, St Vincent’s Hospital Melbourne, St Vincent’s Health Australia, Melbourne, Australia

    Daniel Shell

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Shell, D. Improving survival after pulmonary metastasectomy for sarcoma: analysis of prognostic factors. Gen Thorac Cardiovasc Surg 71, 263–271 (2023). https://doi.org/10.1007/s11748-023-01905-y

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