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. 2021 Nov 10:13:8473-8480.
doi: 10.2147/CMAR.S333721. eCollection 2021.

Clinical Outcome in Soft Tissue Sarcoma Patients with Lung Metastasis Who Received Metastasectomy and/or Radiofrequency Ablation: Tokai Musculoskeletal Oncology Consortium Study

Tomoki Nakamura  1 , Kunihiro Asanuma  1 , Motoshi Takao  2 , Takashi Yamanaka  3 , Hiroshi Koike  4 , Toyofumi F Chen-Yoshikawa  5 , Satoshi Tsukushi  6 , Hiroaki Kuroda  7 , Eiji Kozawa  8 , Masaaki Sano  9 , Hisaki Aiba  10 , Ryoichi Nakanishi  11 , Akihito Nagano  12 , Kenji Yamada  13 , Yoji Shido  14 , Katsuhisa Kawanami  15 , Yuya Izubuchi  16 , Akihiro Sudo  1 , Yoshihiro Nishida  4   17
Affiliations

Clinical Outcome in Soft Tissue Sarcoma Patients with Lung Metastasis Who Received Metastasectomy and/or Radiofrequency Ablation: Tokai Musculoskeletal Oncology Consortium Study

Tomoki Nakamura et al. Cancer Manag Res. .

Abstract

Purpose: Here, we investigated the oncological outcomes of lung metastasectomy and/or radiofrequency ablation (RFA) of 92 patients with soft tissue sarcoma (STS) at nine institutions.

Methods: The study cohort included 65 men and 27 women with a mean age of 59 years at the time of metastasis. The mean follow-up duration was 51 months. All patients underwent metastasectomy and/or RFA for lung metastasis.

Results: The mean maximum size of the initial lung metastasis was 14.6 mm. At the initial evaluation, 41 patients had a single metastasis, whereas 51 patients had multiple metastases. The mean number of metastasectomies and/or RFA was 2 per patient. A total of 70 patients underwent lung metastasectomy, whereas the other 13 underwent lung RFA. The remaining nine patients underwent both RFA and metastasectomy. The 5-year post-metastatic survival rate was 52%. The patients who underwent complete treatment for the initial metastasis had better post-metastatic survival rates than those who underwent incomplete treatment. A univariate analysis of all possible prognostic factors for complete treatment confirmed the predictive value of disease-free interval, metastasis at initial presentation, distribution, tumor size, and number of lung metastases. Of the 92 patients, 74 underwent complete treatment for initial metastasis; in these patients, univariate and multivariate analyses showed that a smaller tumor size and single-lung metastasis were prognostic factors for superior post-metastatic survival. The patients with a smaller (<11.5 mm) single metastasis had better post-metastasis survival. The 5-year post-metastatic survival rates were 89.9% for patients with a smaller (<11.5 mm) single metastasis versus 22.7% for patients with larger (>11.5 mm) and multiple metastases.

Discussion: We propose that complete treatment for lung metastasis in patients with STS may improve post-metastatic survival rates. Furthermore, tumor number and size are important variables for clinical decision-making.

Keywords: lung metastasis; metastasectomy; radiofrequency ablation; soft tissue sarcoma.

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Conflict of interest statement

The authors declare no conflicts of interest for this study.

Figures

Figure 1
Figure 1
Kaplan–Meier curves showing the post-metastatic survival of 92 patients with soft tissue sarcoma after initial lung metastasis.
Figure 2
Figure 2
Kaplan–Meier curves showing post-metastatic survival according to the curability of the initial lung metastasis (A: complete treatment, B: incomplete treatment).
Figure 3
Figure 3
Kaplan–Meier curves showing the post-metastatic survival of 72 patients according to the curability of the initial lung metastasis (A: single and smaller [<11.5 mm]; B: multiple and smaller [<11.5 mm], C; single and larger [>11.5 mm], D; multiple and larger [>11.5 mm]).
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