Differing determinants of prognosis following resection of pulmonary metastases from osteogenic and soft tissue sarcoma patients

Open Access
Publisher Website
Google Scholar
Abstract
A study was performed to determine if prognostic factors could be used preoperatively to predict outcome following resection of metastases. Sixty‐seven soft tissue sarcoma (STS) patients (median follow‐up, 36 months) and 39 osteogenic sarcoma patients (OGS) (median follow‐up, 29 months) underwent thoracic exploration at the first indication of pulmonary metastases, and the results for each group were reviewed. The number of metastatic nodules, disease‐free interval (DFI), and tumor doubling time (TDT) significantly correlated with postoperative survival for STS patients. Patients with four or fewer nodules on preoperative linear tomograms survived longer (median, 23 months) than patients with more than four nodules (median, 6 months; P < 0.005). Patients with a DFI > 12 months had a longer survival (median, 30 months) than patients with a DFI > 12 months (median, 10 months; P < 0.005). Patients with a TDT > 20 days had a longer survival (median, 22 months) than patients with a TDT < 20 days (median, 6 months; P < 0.005). The only significant predictor of survival for OGS patients was the number of nodules on preoperative linear tomograms (⩽4, 37 months median survival;>4, 10 months median survival; P < 0.05). This was due to significant differences noted for the DFI and TDT distributions between OGS and STS patients, with most OGS patients having a short DFI (⩽12 months) and a rapid TDT (⩽20 days) whereas STS patients had a more heterogeneous distribution (P < 0.01). Thus, the number of metastases visible on the preoperative tomogram was the best predictor of survival for both OGS and STS patients. However, the applicability of other prognostic factors could not be generalized for these two closely related groups of patients. Cancer 55:1361‐1366, 1985.