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软组织肉瘤肺转移瘤切除术中原发肿瘤在肺转移之前复发的意义。

Significance of tumor recurrence before pulmonary metastasis in pulmonary metastasectomy for soft tissue sarcoma.

作者信息

Chen F, Fujinaga T, Sato K, Sonobe M, Shoji T, Sakai H, Miyahara R, Bando T, Okubo K, Hirata T, Date H

机构信息

Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Eur J Surg Oncol. 2009 Jun;35(6):660-5. doi: 10.1016/j.ejso.2008.07.015. Epub 2008 Sep 6.

Abstract

BACKGROUND

Resection for pulmonary metastasis from soft tissue sarcomas is an accepted method for treatment, but it is still debatable which patients will benefit from surgical intervention. To find an entity of patients benefiting from pulmonary metastasectomy, we reviewed our institutional experience.

METHODS

Between 1990 and 2007, 23 patients with pulmonary metastases from soft tissue sarcomas underwent complete pulmonary resection. All patients had obtained locoregional control of their primary tumors. Various perioperative variables were investigated retrospectively to confirm the role of pulmonary metastasectomy and to identify possible prognostic factors for survival after metastasectomy.

RESULTS

Overall survival rate after metastasectomy was 43% and 29% at 5 and 10 years, respectively. Disease-free survival rate was 9% at 1 year after pulmonary resection. On multivariate analysis, no tumor recurrence (neither locoregional recurrence nor extrapulmonary metastasis) before pulmonary metastasis provided a significantly favorable overall survival (P=0.038). In addition, repeat metastasectomy for recurrent pulmonary metastasis also provided a favorable overall survival (P=0.041).

CONCLUSIONS

Our data suggested that patients most likely to benefit from pulmonary metastasectomy for soft tissue sarcoma have no tumor recurrence before pulmonary metastasis. Furthermore, patients with repeat metastasectomy for recurrent pulmonary metastasis also presented a significantly longer survival.

摘要

背景

软组织肉瘤肺转移灶切除术是一种公认的治疗方法,但哪些患者将从手术干预中获益仍存在争议。为了找出能从肺转移瘤切除术中获益的患者群体,我们回顾了我们机构的经验。

方法

1990年至2007年间,23例软组织肉瘤肺转移患者接受了肺全切术。所有患者的原发肿瘤均已获得局部区域控制。回顾性研究了各种围手术期变量,以证实肺转移瘤切除术的作用,并确定转移瘤切除术后可能的生存预后因素。

结果

转移瘤切除术后5年和10年的总生存率分别为43%和29%。肺切除术后1年的无病生存率为9%。多因素分析显示,肺转移前无肿瘤复发(包括局部区域复发和肺外转移)的患者总生存率显著更高(P=0.038)。此外,复发性肺转移的再次转移瘤切除术也能带来较好的总生存率(P=0.041)。

结论

我们的数据表明,软组织肉瘤患者中最有可能从肺转移瘤切除术中获益的是那些在肺转移前无肿瘤复发的患者。此外,复发性肺转移接受再次转移瘤切除术的患者生存期也显著延长。

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