Pulmonary metastasectomy for sarcoma: Insights from a referral-center cohort.

IF 3.5 2区 医学 Q2 ONCOLOGY
Ejso Pub Date : 2024-10-25 DOI:10.1016/j.ejso.2024.108774
Thomas Charrier, Edouard-Frédéric Robin, Vincent De Pauw, Pascaline Boudou-Rouquette, Camille Tlemsani, Guillaume Beinse, Sixtine De Percin, Audrey Lupo, Emelyne Canny, Antonio Bobbio, Marco Alifano, Ludovic Fournel
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引用次数: 0

Abstract

Introduction: The low incidence and heterogeneity of sarcomas limit understanding of their progression in metastatic cases. The use of metastasectomy is debated due to lack of consensus and evidence-based data. This study aimed to identify simple prognostic factors that could contribute to the therapeutic strategy.

Methods: We retrospectively reviewed all patients undergoing pulmonary metastasectomy from sarcoma in our referral center between 2011 and 2022. Demographic, radiologic, pathologic, and operative data were collected. Oncological follow-up, survival, and risk factor analyses were performed.

Results: 192 patients were identified (mean age 49.3 years). Primary sarcoma arose from the trunk (24.6 %) or limbs (75.4 %), and metastases were metachronous in 85.4 % of cases. The median number of operated lesions was 2, and anatomic resection were performed in 24.1 %. The postoperative course was uneventful in 91.3 % of cases. Post-operative chemotherapy followed lung resection in 68.7 %. 1-, 3-, and 5-year Overall Survival (OS) were 89.6 %, 69.8 %, 57.6 %, respectively, with a plateau phase beyond 5 years. Higher grade or trunk location of the primary sarcoma, incomplete or anatomic pulmonary resection, and post-operative systemic treatment were significantly associated with shorter OS. No histological subtype significantly impacted OS. Location of the primary, resection type, and post-operative systemic treatment independently influenced OS. Non-anatomic and repeated pulmonary resections, were independently associated with "long surviving".

Conclusion: In metastatic sarcoma, pulmonary resections offer prolonged survival in selected patients, supporting its essential role in the whole therapeutic strategy. Anatomic and sequential metastasectomy should be cautiously discussed.

肉瘤肺转移切除术:转诊中心队列的启示。
导言:肉瘤发病率低且具有异质性,这限制了人们对其转移病例进展情况的了解。由于缺乏共识和循证数据,对转移瘤切除术的使用存在争议。本研究旨在找出有助于制定治疗策略的简单预后因素:我们回顾性分析了 2011 年至 2022 年期间在我们的转诊中心接受肺转移瘤切除术的所有患者。我们收集了人口统计学、放射学、病理学和手术数据。进行了肿瘤随访、生存率和风险因素分析:共发现 192 名患者(平均年龄 49.3 岁)。原发性肉瘤来自躯干(24.6%)或四肢(75.4%),85.4%的病例为转移瘤。手术病灶的中位数为2个,24.1%的病例进行了解剖切除。91.3%的病例术后恢复顺利。68.7%的患者在肺切除术后接受了化疗。1年、3年和5年总生存率(OS)分别为89.6%、69.8%和57.6%,5年后进入稳定期。原发性肉瘤的分级或躯干位置较高、肺部切除不彻底或解剖不完整以及术后系统治疗与较短的OS显著相关。没有一种组织学亚型会明显影响患者的生存期。原发位置、切除类型和术后系统治疗对手术生存期有独立影响。结论:在转移性肉瘤中,肺切除与 "长期存活 "密切相关:结论:在转移性肉瘤中,肺切除术可延长特定患者的生存期,支持其在整个治疗策略中的重要作用。应谨慎讨论解剖性和连续性转移瘤切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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