Prognostic influence of the treatment approach for pulmonary metastasis in patients with soft tissue sarcoma View Full Text


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Article Info

DATE

2020-05-20

AUTHORS

Teruya Kawamoto, Hitomi Hara, Masayuki Morishita, Naomasa Fukase, Yohei Kawakami, Toshiyuki Takemori, Shuichi Fujiwara, Kazumichi Kitayama, Shunsuke Yahiro, Tomohiro Miyamoto, Takuya Fujimoto, Ikuo Fujita, Kenichiro Kakutani, Tomoyuki Matsumoto, Takehiko Matsushita, Takahiro Niikura, Ryosuke Kuroda, Toshihiro Akisue

ABSTRACT

Soft tissue sarcomas (STSs) are rare heterogeneous malignancies of mesenchymal origin. Pulmonary metastases develop in approximately 50% of the patients with high-grade STS, being the major cause of mortality in patients with metastatic STS. Pulmonary metastasectomy has been reported to contribute to long-term survival; however, an appropriate treatment has not been established. We aimed to identify factors associated with post-metastasis survival in STS patients with pulmonary metastasis and determine the appropriate treatment for each patient. We retrospectively reviewed the records of metastatic STS patients treated between 2000 and 2017 and analyzed the clinico-pathologic variables to identify factors associated with the survival. The median survival after pulmonary metastasis was 20.6 months, and the 1-, 3-, and 5-year survival rates were 68.6%, 36.0%, and 25.1%, respectively. The survival was significantly greater in patients who underwent pulmonary metastasectomy than in those without surgery (38.9 months vs. 10.5 months; p < 0.0001). Among those who did not undergo surgery, the survival was significantly greater in patients who received chemotherapy than in those without chemotherapy (19.1 months vs. 6.3 months, p = 0.037). Multivariate analysis identified pulmonary metastasectomy as the most important prognostic factor for post-metastasis survival (Hazard ratio 5.623; 95% Confidence Interval 2.733–11.572; p < 0.0001). In conclusion, pulmonary metastasectomy was the most important prognostic factor for post-metastasis survival in patients with metastatic STS. In addition, chemotherapy could prolong survival in patients who were not eligible for pulmonary resection. Although we should carefully weigh the risks and benefits, appropriate treatment for pulmonary metastases could contribute to long-time survival. More... »

PAGES

509-517

References to SciGraph publications

  • 2010-08-20. The Burden of Rare Cancers in Europe in RARE DISEASES EPIDEMIOLOGY
  • 2008-08-29. The clinical efficacy of 18F-FDG-PET/CT in benign and malignant musculoskeletal tumors in ANNALS OF NUCLEAR MEDICINE
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    URI

    http://scigraph.springernature.com/pub.10.1007/s10585-020-10038-y

    DOI

    http://dx.doi.org/10.1007/s10585-020-10038-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1127766339

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32436018


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