Objective

Soft tissue sarcomas are rare neoplasms of which one fifth metastasise, most commonly to the lungs. Patients have a significant burden of disease with poor survival rates. Studies have shown that lung resection, in particular repeated resections, can improve survival but outcomes from different types of surgeries have not been compared. Our aim was to analyse patients in this disease category undergoing lung resection at a tertiary thoracic centre serviced by a regional sarcoma MDT.

Methods

We carried out a retrospective data collection of all patients undergoing lung resection for sarcoma metastasis. Data was collected over a 17-year time period, between years 1996 – 2013, primarily from histology records of lung specimens and was cross referenced with patient records. A total of 56 records were identified: 32 males; 24 females, mean age 50 (range 11 – 84). Primary outcome measure was mortality. Follow up was 100% complete.

Results

Most common histological types: leiomyosarcoma (31%), pleomorphic (23%), osteosarcoma (14%). Types of resection: metastatectomy 31%, lobectomy 21%, pneumonectomy 7%, combination 41%. Overall survival was 64% at 1 year, 40% at 3 years, 28% at 5 years. Improved survival was found in patients with MPNST on histology, unilateral tumours and fewer tumours. Metastatectomy conferred significantly improved survival rates compared to anatomical resection (HR 0.69, 95% CI 0.51 - 0.88).

Conclusion

Pulmonary metastatectomy for sarcoma secondaries can be performed safely with good outcomes. It also offers the ability of repeated metastectomy and improved survival at 5 years than anatomical resection. Multi‐modality treatment in the setting of a regional sarcoma MDT is valuable in this specialist area of thoracic surgery. We feel our findings create an impetus to pool more results nationally in this field.