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Titel:

Does Size Outweigh Number in Predicting Survival After Pulmonary Metastasectomy for Soft Tissue Sarcoma? Insights from a Retrospective Multicenter Study.

Dokumenttyp:
Journal Article; Multicenter Study
Autor(en):
Burkhard-Meier, Anton; Grube, Matthias; Jurinovic, Vindi; Agaimy, Abbas; Albertsmeier, Markus; Berclaz, Luc M; Di Gioia, Dorit; Dürr, Hans Roland; von Eisenhart-Rothe, Rüdiger; Eze, Chukwuka; Fechner, Katja; Fey, Emma; Güler, Sinan E; Hecker, Judith S; Hendricks, Anne; Keil, Felix; Klein, Alexander; Knebel, Carolin; Kovács, Julia R; Kunz, Wolfgang G; Lenze, Ulrich; Lörsch, Alisa M; Lutz, Mathias; Meidenbauer, Norbert; Mogler, Carolin; Schmid, Sebastian; Schmidt-Hegemann, Nina-Sophie; Schneider,...     »
Abstract:
BACKGROUND: Pulmonary metastasectomy (PM) is the most frequently performed local ablative therapy for leiomyosarcoma (LMS), synovial sarcoma (SyS), and undifferentiated pleomorphic sarcoma (UPS). This study aimed to assess surgical feasibility, outcome, and clinical prognostic factors, as well as the value of a peri-interventional systemic therapy. METHODS: This multicenter retrospective study enrolled 77 patients with LMS, SyS, or UPS who underwent first-time complete resection of isolated lung metastases between 2009 and 2021. Disease-free survival (DFS), overall survival (OS), and clinical prognostic factors were analyzed. RESULTS: After the first PM, the median DFS was 7.4 months, and the median OS was 58.7 months. A maximal lesion diameter greater than 2 cm was associated with reduced DFS in both the univariable (hazard ratio [HR], 2.29; p = 0.006) and multivariable (HR, 2.60; p = 0.005) analyses. The univariable analysis identified a maximal lesion diameter greater than 2 cm as an adverse prognostic factor for OS (HR, 5.6; p < 0.001), whereas a treatment-free interval longer than 12 months was associated with improved OS (HR, 0.42; p = 0.032). The addition of systemic therapy was associated with a trend toward improved DFS for patients with lesions larger than 2 cm (HR, 0.29; p = 0.063). Severe postoperative complications (grade ≥IIIa) occurred in 2 % of the patients. CONCLUSION: The size of resected lung metastases might be a more relevant prognostic factor than their number for patients with LMS, SyS, or UPS. For patients with lung metastases larger than 2 cm in maximal diameter, additional systemic therapy may be warranted.
Zeitschriftentitel:
Ann Surg Oncol
Jahr:
2025
Band / Volume:
32
Heft / Issue:
8
Seitenangaben Beitrag:
5948-5956
Volltext / DOI:
doi:10.1245/s10434-025-17450-2
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/40369396
Print-ISSN:
1068-9265
TUM Einrichtung:
1741; 591; 595; 608; 663; Institut für Allgemeine Pathologie und Pathologische Anatomie (Dr. Mogler komm.); Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann); Klinik und Poliklinik für Orthopädie und Sportorthopädie (Prof. von Eisenhart-Rothe)
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