Pastorino U, Valente M, Gasparini M, Azzarelli A, Santoro A, Alloisio M, Ongari M, Tavecchio L, Ravasi G
Division of Thoracic Surgery, Istituto Nazionale Tumori, Milan, Italy.
J Surg Oncol. 1989 Apr;40(4):275-80. doi: 10.1002/jso.2930400414.
The results of surgical management of 63 cases of pulmonary metastases from bone and soft tissue sarcomas, admitted at the Istituto Nazionale Tumori of Milan, between 1970 and 1987, are reviewed in this paper. To estimate the relative impact of metastasectomy on the overall performance of treatment, survival curves were calculated from the time of first thoracotomy, as well as from the initial treatment of primary sarcoma. In the present series, total actuarial survival at 10 years was 37% for osteosarcoma, 27% for soft tissue sarcomas, and 24% for the other bone sarcomas, with a median survival of 48, 56, and 36 months, respectively. Five-year survival from the first pulmonary resection was influenced by the number of metastases and the length of the first disease-free interval only in osteosarcoma, while in soft tissue sarcomas a major untoward factor was represented by local recurrence at the site of the primary tumor. These data support the concept of pulmonary metastasectomy as effective salvage therapy for radically treated sarcomas; this management can rescue a significant proportion of all relapsed patients.
本文回顾了1970年至1987年间米兰国立肿瘤研究所收治的63例骨肉瘤和软组织肉瘤肺转移患者的外科治疗结果。为评估肺转移瘤切除术对整体治疗效果的相对影响，从首次开胸手术时间以及原发性肉瘤的初始治疗时间开始计算生存曲线。在本系列研究中，骨肉瘤10年总精算生存率为37%，软组织肉瘤为27%，其他骨肉瘤为24%，中位生存期分别为48、56和36个月。仅在骨肉瘤中，首次肺切除术后的5年生存率受转移灶数量和首个无病间期时长的影响，而在软组织肉瘤中，主要的不良因素是原发肿瘤部位的局部复发。这些数据支持了肺转移瘤切除术作为根治性治疗肉瘤有效挽救疗法的概念；这种治疗方法可以挽救相当一部分复发患者。
