154P - Surgical treatment of synchronous lung metastasis in patient with osteosarcomas and soft tissue sarcomas

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Sarcoma
Surgery and/or Radiotherapy of Cancer
Presenter Evgeny Smolenov
Citation Annals of Oncology (2015) 26 (suppl_1): 45-47. 10.1093/annonc/mdv051
Authors E. Smolenov1, Y. Ragulin1, A. Starodubtcev2, A. Kurilchik2, V. Usachev1, A. Zubarev2, V. Ivanov2
  • 1Thoracic Department, Medical Radiological Research Center, 249036 - Obninsk/RU
  • 2Radiology Department, Medical Radiological Research Center, 249036 - Obninsk/RU

Abstract

Aim/Background

Patients with sarcomas and simultaneously having synchronous lung metastases survive for shorter duration and show poor quality of life. Chemotherapy is considered as a standard treatment for these patients and the benefit of surgical resection of residual lung metastases is controversial. We analyzed our experience on surgical treatment of such patients.

Methods

We performed a single center retrospective study of 15 patients, medium age 38.5 years (range 19-72), 9 males, with synchronous lung metastases, hospitalized between 2001 and 2014. Nine patients had primary diagnosis of osteosarcoma and six patients had diagnosis of soft tissue sarcoma. 13 patients received preoperative treatment to the primary tumor (radiation therapy in 8 patients, chemotherapy in 5 patients). 13 patients had bilateral nodes in the lungs. All patients underwent surgical resection of lung metastases (from 1 to 103, mean – 16,4), bilateral thoracotomy with surgical resection of metastases was performed in 7 patients.

Results

In 3 patients metastatic process in lungs was not confirmed (tuberculosis, local fibrosis and multiple hamartomas). In 2 patients a postoperative pneumothorax was observed; 1 case required drainage. Other complications include anemia and shortness of breath, subcutaneous emphysema and pleuropneumonia were cured with medication. There was no treatment related mortality at 30 days. In all cases intraoperative palpation revealed more metastases than visualized by CT before surgery. The median overall survival was 9 months with 30% (10%) of patients alive at 1 (2) years.

Conclusions

Distant metastases is associated with extremely poor survival of patients with sarcomas. Aggressive surgery for the primary and metastatic sites is one of the options for such patients. Surgical interventions in patients with non-confirmed lung metastatic process might change the treatment strategy. Further studies are needed to assess the impact of surgical treatment on survival rate and quality of life.

Disclosure

All authors have declared no conflicts of interest.