Abstract

BACKGROUND: Surgical resection for sarcoma lung metastases has been associated with improved overall survival (OS).METHODS: Patients who underwent curative-intent resection of sarcoma lung metastases (2000-2016) were identified from the US Sarcoma Collaborative. Patients with extrapulmonary metastatic disease or R2 resections of primary tumor or metastases were excluded. Primary endpoint was OS.RESULTS: Three hundred and fifty-twopatients met inclusion criteria. Location ofprimary tumor was truncal/extremity in 85% (n=270) and retroperitoneal in 15% (n=49). Forty-nine percent (n=171) of patients had solitary and 51% (n=180) had multiple lung metastasis. Median OS was 49 months; 5-year OS 42%. Age =55 (HR1.77), retroperitoneal primary (HR 1.67), R1 resection of primary (HR 1.72), and multiple (=2) lung metastases (HR 1.77) were associated with decreased OS(all p<0.05). Assigning one point for each factor, we developed a risk score from 0 to 4. Patients were then divided into two risk groups: low (0-1 factor) and high (2-4 factors). The low-risk group (n=159) had significantly better 5-year OS compared to the high-risk group (n=108) (51% vs.16%,p<0.001).CONCLUSION: We identified four characteristics that in aggregate portend a worse OS and created a novel prognostic risk score for patients with sarcoma lung metastases. Given that patients in the high-risk group have a projected OS of <20% at 5 years, this risk score, after external validation, will be an important tool to aid in preoperative counseling and consideration for multimodal therapy.

View details for DOI 10.1002/jso.26635

View details for PubMedID 34374088