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The Journal of Thoracic and Cardiovascular Surgery, Vol 87, 260-268, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JB Putnam Jr, JA Roth, MN Wesley, MR Johnston and SA Rosenberg
The selection of objective criteria that can reliably predict survival in
patients undergoing resection of pulmonary metastases remains
controversial. Between 1974 and 1982, 487 patients with soft tissue
sarcomas presented to the National Cancer Institute. Eighty patients
underwent thoracotomy for putative metastases and 67 patients had
histologically proved pulmonary metastases. The 3 year tumor-free survival
rate was 30% by actuarial analysis. Patients with resectable metastases had
significantly prolonged post-thoracotomy survival compared to those
patients with unresectable metastases. The most significant preoperative
predictors of survival were the tumor doubling time, the number of
metastases on preoperative linear chest tomograms, and the disease-free
interval. Patients with a tumor doubling time of 20 days or more had a
significantly longer post-thoracotomy survival (22 months median) than
patients with a tumor doubling time of less than 20 days (6 months median).
Those patients with four nodules or less on preoperative tomograms had
significantly longer post- thoracotomy survival times (23 months median)
than those patients with more than four nodules (6 months median). Patients
with a disease-free interval of more than 12 months had a longer
post-thoracotomy survival (32 months median) than patients with a
disease-free interval of 12 months or less (10 months median). Combining
these three prognostic factors significantly increased the predictive
ability of this model. These criteria provide an accurate and rapid method
to identify preoperatively those patients who will maximally benefit from
resection of pulmonary metastases from soft tissue sarcomas.
ARTICLES
Analysis of prognostic factors in patients undergoing resection of pulmonary metastases from soft tissue sarcomas
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