Pulmonary metastatectomy for soft XXXX : is it valuable?

@entity1 @entity3 @entity5 @entity242
BACKGROUND: A retrospective study and analysis was performed to determine the value and benefit of pulmonary metastatectomy for soft @entity242 , and which factors predict prognosis following resection. METHODS: Twenty-three @entity1 underwent resections for pulmonary @entity3 from a soft tissue @entity242 (STS) at King Faisal Specialist Hospital and Research Center (KFSH_RC), between January 1985 and December 1998. There were 11 male and 12 female @entity1 . Thirteen of 23 @entity1 (57%) had one to three @entity3 , and 10 (43%) had four or more @entity3 . A total of 41 thoracic explorations was performed for the 23 evaluable @entity1 . Median sternotomy was used only for three @entity1 and lateral thoracotomy was used for 20 @entity1 as an initial surgical approach. Pulmonary resections performed included one or more wedge resections (n=16), segmentectomy (n=5), and lobectomy (n=2). No one in this series underwent pneumonectomy. The number of resected metastatic nodules ranged from one-six with average three. Eight @entity1 (35%) received various kinds of postoperative adjuvant chemotherapy. RESULTS: The overall and disease-free survival rate post-metastatectomy at five years was 24% and 21%, respectively. Various prognostic indicators were examined to evaluate their association with improved survival. Age, sex localization of the primary site and histologic type, @entity5 grade, size of the resected nodules, laterality (unilateral or bilateral), types of resection, adjuvant chemotherapy, and local recurrence did not significantly affect survival. However, @entity1 with disease free interval >6 months, and those with three or fewer @entity3 showed a trend toward a higher five-year overall survival (p=0.06, 0.07, respectively). CONCLUSIONS: Surgical excision of lung @entity3 from soft @entity242 is well accepted and should be considered as a first line of treatment if preoperative evaluation indicated that complete resection of the @entity3 is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy.
