Prognostic Factors for Pulmonary Metastasectomy in Soft Tissue Sarcoma: An Integrative Review

Abstract

The lung is one of the most common sites of metastasis from soft tissue sarcoma (STS). In the absence of a randomized control trial, pulmonary metastasectomy is commonly performed in an effort to improve survival. However, data from retrospective analysis and case series remain subject to selection bias. The aim of this study was to review the published data, especially to identify prognostic factors, to inform future clinical practice in the field of pulmonary metastasectomy for metastatic soft tissue sarcoma. We searched the SCOPUS database using the terms "pulmonary metastasectomy" or "lung resection" or "lung metastasectomy" or lung metastasectomies" and sarcoma and survival in the title, abstract, and keywords of all documents. Over the study period (1976-June 2021), a total of 438 documents of published articles were retrieved and 192 were identified for bibliometric analysis, and of those, 128 articles were included in the content analysis. No randomized trial was identified. 'Bradford's law' was applied to classify journals into 'zones' and 6 journals appeared to publish 70/192 (36.4%) of all articles, receiving 52% of the citations. The vast majority of articles 64% were retrospective cohort analyses. A total of 49 articles reported on prognostic factors. Pulmonary metastasectomy is frequently performed for lung metastases originating from STS. The literature continues to evolve in the form of retrospective cohort studies. It is important to review and utilize the prognostic factors to identify patients for pulmonary metastasectomy to enhance the survival outcome.