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Ann Thorac Surg 1991;52:197-203
© 1991 The Society of Thoracic Surgeons

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Articles

Reoperative pulmonary resection in patients with metastatic soft tissue sarcoma

Thoracic Oncology Section, Surgery Branch, and Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

^_* Address reprint requests to Dr Pass, Thoracic Oncology Section, Surgery Branch, National Cancer Institute, National Institutes of Health, Building 10, Room 2B07, Bethesda, MD 20892.

Resection of pulmonary metastases from soft tissue sarcoma has been shown to be associated with a 3-year survival of 25% to 30%. The role of multiple resections for recurrent pulmonary metastases, however, has not been clearly defined. Since 1976, 43 patients have had two or more thoracic explorations for the purpose of resecting pulmonary metastases from adult soft tissue sarcoma at our institution. In 89 reexplorations, through either median sternotomy or lateral thoracotomy, the operative mortality was 0%, and 31 of the 43 patients (72%) could be rendered free of disease at the second thoracotomy. Median survival from the second thoracotomy for the patients with resectable disease was 25 months, whereas median survival of patients who had unresectable disease was 10 months. A disease-free interval between the first and second thoracotomies of greater than 18 months was associated with prolonged survival from the second thoracotomy. Owing to lack of other therapies with proven salvage efficacy and in the absence of randomized trials, repeated thoracotomies to render patients free of disease from pulmonary soft tissue sarcoma metastases appear justified considering the potential survival benefit and low attendant risk.

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