2001 CTOS Annual Meeting Posters— Medical Oncology

PULMONARY METASTASIS IN STS
Matthias Peiper,  Thomas Streichert,  Antja Heinecke,  Jacob R. Izbicki,  Wolfram Trudo Knoefel
Dep. of General Surgery, University Hospital Hamburg-Eppendorf, Germany

METHODS: A retrospective analysis of all patients operated on pulmonary metastasis of STS between 1988 und 1999 was performed. Patients and tumorcharacteristics as well as surgical and pathological results where evaluated.

RESULTS: 52 patients (31 female, 21 male) with a median age of 44 (18-75) years were operated. Primary tumors included leiomyosarcomas (n=13, 23%), MFH (n=10, 19%), MPNST (n=6, 13%) and 23 tumors of 11 other entities 42% of patients have been already treated with primary STS in our institution. Primary tumors were located subcutaneous in 12 patients, subfascial in 25 patients and in 15 patients in parenchymatous organs. Half of primary STS were poorly differentiated, while 30% were moderate and 20% were well differentiated. 29% of primary tumors had been resected achieving wide margins (R0), 71% R1. In 12,5% of patients, distant metastasis were present at initial diagnosis. In 40 patients chemotherapy had been administered (not in randomized trials), 26 of these after diagnosis of pulmonary metastasis. In 28 patients local recurrence occurred, in 25 of these before or simultaneously with pulmonary metastasis. Patients were operated by thoracotomie or sternotomie no patient was operated using thoracoscopy. Up to 4 operations were performed per patient and up to 38 pulmonary tumors were resected. At the end of follow up – 14 patients are alive, while 38 died due to tumor disease. Mean over all survival time was 37 months and 20 months after metastasectomy. No significant statistic parameters were found associated with reduced survival.

CONCLUSION: Though most patients with pulmonary STS metastasis will eventually die due to tumor disease, curations are noted and over all survival is better than and most other malignancies. Even recurrent metastasectomy may be indicated in selected patients.