Pulmonary metastasectomy for sarcoma: Insights from a referral-center cohort.

IF 3.5 2区 医学 Q2 ONCOLOGY Ejso Pub Date : 2024-10-25 DOI:10.1016/j.ejso.2024.108774
Thomas Charrier, Edouard-Frédéric Robin, Vincent De Pauw, Pascaline Boudou-Rouquette, Camille Tlemsani, Guillaume Beinse, Sixtine De Percin, Audrey Lupo, Emelyne Canny, Antonio Bobbio, Marco Alifano, Ludovic Fournel
{"title":"Pulmonary metastasectomy for sarcoma: Insights from a referral-center cohort.","authors":"Thomas Charrier, Edouard-Frédéric Robin, Vincent De Pauw, Pascaline Boudou-Rouquette, Camille Tlemsani, Guillaume Beinse, Sixtine De Percin, Audrey Lupo, Emelyne Canny, Antonio Bobbio, Marco Alifano, Ludovic Fournel","doi":"10.1016/j.ejso.2024.108774","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The low incidence and heterogeneity of sarcomas limit understanding of their progression in metastatic cases. The use of metastasectomy is debated due to lack of consensus and evidence-based data. This study aimed to identify simple prognostic factors that could contribute to the therapeutic strategy.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients undergoing pulmonary metastasectomy from sarcoma in our referral center between 2011 and 2022. Demographic, radiologic, pathologic, and operative data were collected. Oncological follow-up, survival, and risk factor analyses were performed.</p><p><strong>Results: </strong>192 patients were identified (mean age 49.3 years). Primary sarcoma arose from the trunk (24.6 %) or limbs (75.4 %), and metastases were metachronous in 85.4 % of cases. The median number of operated lesions was 2, and anatomic resection were performed in 24.1 %. The postoperative course was uneventful in 91.3 % of cases. Post-operative chemotherapy followed lung resection in 68.7 %. 1-, 3-, and 5-year Overall Survival (OS) were 89.6 %, 69.8 %, 57.6 %, respectively, with a plateau phase beyond 5 years. Higher grade or trunk location of the primary sarcoma, incomplete or anatomic pulmonary resection, and post-operative systemic treatment were significantly associated with shorter OS. No histological subtype significantly impacted OS. Location of the primary, resection type, and post-operative systemic treatment independently influenced OS. Non-anatomic and repeated pulmonary resections, were independently associated with \"long surviving\".</p><p><strong>Conclusion: </strong>In metastatic sarcoma, pulmonary resections offer prolonged survival in selected patients, supporting its essential role in the whole therapeutic strategy. Anatomic and sequential metastasectomy should be cautiously discussed.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ejso","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ejso.2024.108774","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: The low incidence and heterogeneity of sarcomas limit understanding of their progression in metastatic cases. The use of metastasectomy is debated due to lack of consensus and evidence-based data. This study aimed to identify simple prognostic factors that could contribute to the therapeutic strategy.

Methods: We retrospectively reviewed all patients undergoing pulmonary metastasectomy from sarcoma in our referral center between 2011 and 2022. Demographic, radiologic, pathologic, and operative data were collected. Oncological follow-up, survival, and risk factor analyses were performed.

Results: 192 patients were identified (mean age 49.3 years). Primary sarcoma arose from the trunk (24.6 %) or limbs (75.4 %), and metastases were metachronous in 85.4 % of cases. The median number of operated lesions was 2, and anatomic resection were performed in 24.1 %. The postoperative course was uneventful in 91.3 % of cases. Post-operative chemotherapy followed lung resection in 68.7 %. 1-, 3-, and 5-year Overall Survival (OS) were 89.6 %, 69.8 %, 57.6 %, respectively, with a plateau phase beyond 5 years. Higher grade or trunk location of the primary sarcoma, incomplete or anatomic pulmonary resection, and post-operative systemic treatment were significantly associated with shorter OS. No histological subtype significantly impacted OS. Location of the primary, resection type, and post-operative systemic treatment independently influenced OS. Non-anatomic and repeated pulmonary resections, were independently associated with "long surviving".

Conclusion: In metastatic sarcoma, pulmonary resections offer prolonged survival in selected patients, supporting its essential role in the whole therapeutic strategy. Anatomic and sequential metastasectomy should be cautiously discussed.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
肉瘤肺转移切除术:转诊中心队列的启示。
导言:肉瘤发病率低且具有异质性,这限制了人们对其转移病例进展情况的了解。由于缺乏共识和循证数据,对转移瘤切除术的使用存在争议。本研究旨在找出有助于制定治疗策略的简单预后因素:我们回顾性分析了 2011 年至 2022 年期间在我们的转诊中心接受肺转移瘤切除术的所有患者。我们收集了人口统计学、放射学、病理学和手术数据。进行了肿瘤随访、生存率和风险因素分析:共发现 192 名患者(平均年龄 49.3 岁)。原发性肉瘤来自躯干(24.6%)或四肢(75.4%),85.4%的病例为转移瘤。手术病灶的中位数为2个,24.1%的病例进行了解剖切除。91.3%的病例术后恢复顺利。68.7%的患者在肺切除术后接受了化疗。1年、3年和5年总生存率(OS)分别为89.6%、69.8%和57.6%,5年后进入稳定期。原发性肉瘤的分级或躯干位置较高、肺部切除不彻底或解剖不完整以及术后系统治疗与较短的OS显著相关。没有一种组织学亚型会明显影响患者的生存期。原发位置、切除类型和术后系统治疗对手术生存期有独立影响。结论:在转移性肉瘤中,肺切除与 "长期存活 "密切相关:结论:在转移性肉瘤中,肺切除术可延长特定患者的生存期,支持其在整个治疗策略中的重要作用。应谨慎讨论解剖性和连续性转移瘤切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
期刊最新文献
Calendar of events Editorial Board Reply to: “Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy” Optimizing the clinical utilization of geriatric nutritional risk index in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy Letter to the editor: “Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma”
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1