Rehders Alexander, Hosch Stefan B, Scheunemann Peter, Stoecklein Nikolas H, Knoefel Wolfram T, Peiper Matthias
Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Düsseldorf, Heinrich-Heine Universität, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
Arch Surg. 2007 Jan;142(1):70-5; discission 76. doi: 10.1001/archsurg.142.1.70.
Patients with pulmonary metastatic soft tissue sarcoma benefit from resection, with long-term cure possible.
Retrospective medical records review.
Academic tertiary care center.
Between January 1, 1991, and December 31, 2002, 61 patients (33 men and 28 women; median age at initial diagnosis, 42 years [age range, 18-74 years]) were surgically treated for pulmonary metastases of soft tissue sarcoma at University Hospital, Hamburg-Eppendorf, Germany.
Sternotomy or anterior lateral thoracotomy was performed for metastasectomy, including wedge resection or lobectomy.
The effects of clinical and pathologic factors on disease-specific survival were analyzed using the log rank test and a multivariate Cox proportional hazards model.
Primary tumor size was pT1 in 13 patients and pT2 in 48 patients. The differentiation was high in 7 patients, intermediate in 19 patients, and low in 35 patients. The mean number of resected pulmonary metastatic lesions was 5 (range, 1-48). An anterolateral thoracotomy was performed in 39 patients, and sternotomy in 22 patients. There were no significant postoperative complications that required surgical revision. The perioperative mortality was 0%. At a mean follow-up of 60 months, the mean survival time after metastasectomy was 33 months (range, 2-125 months). The 5-year survival was 25%. The number of resected lung metastatic lesions had no prognostic relevance (P = .37).
Patients with lung metastasis from soft tissue sarcomas benefit from surgical excision. This treatment has low complication rates and has a favorable influence on the course of the disease. Long-term survival is possible even when recurrent pulmonary disease is resected.
肺转移性软组织肉瘤患者可从手术切除中获益，有可能实现长期治愈。
回顾性病历审查。
学术性三级医疗中心。
在1991年1月1日至2002年12月31日期间，德国汉堡-埃彭多夫大学医院对61例软组织肉瘤肺转移患者进行了手术治疗（33例男性和28例女性；初次诊断时的中位年龄为42岁[年龄范围18 - 74岁]）。
采用胸骨切开术或前外侧开胸术进行转移灶切除术，包括楔形切除术或肺叶切除术。
使用对数秩检验和多变量Cox比例风险模型分析临床和病理因素对疾病特异性生存的影响。
原发肿瘤大小为pT1的患者有13例，pT2的患者有48例。7例患者分化程度高，19例患者分化程度中等，35例患者分化程度低。切除的肺转移灶平均数量为5个（范围1 - 48个）。39例患者采用前外侧开胸术，22例患者采用胸骨切开术。没有需要手术修正的严重术后并发症。围手术期死亡率为0%。平均随访60个月，转移灶切除术后的平均生存时间为33个月（范围2 - 125个月）。5年生存率为25%。切除的肺转移灶数量无预后相关性（P = 0.37）。
软组织肉瘤肺转移患者可从手术切除中获益。这种治疗并发症发生率低，对疾病进程有有利影响。即使复发性肺部疾病被切除，也有可能实现长期生存。
