Abstract 96P
Background
This study assesses whether high-intensity pulmonary metastasectomy is a safe and effective treatment in patients with alveolar soft part sarcoma (ASPS). It offers insights from the largest single-center series of ASPS patients undergoing this procedure, emphasizing its efficacy and safety.
Methods
This study investigates patients suffering from ASPS, an ultra-rare subtype of soft tissue sarcoma that frequently metastasizes to the lungs, who underwent bilateral high-intensity pulmonary metastasectomy (>10 metastases/side) via thoracotomy using advanced 1318 nm laser resection techniques between 2004 and 2020 in our high-volume center. Data concerning medical history, histology, and clinical parameters were extracted from the medical database of the Department of Thoracic Surgery. Survival status was obtained from patients or GPs if no data were available.
Results
We analyzed 11 males and 6 females treated with ASPS. The median age of patients at the time of metastasectomy was 30.3 years (range 12 to 48 years). The majority of these primary tumors were located in the limbs. The primary tumor was resected at the time of metastasectomy, 7 out of 17 patients received local radiation at the resection site. 9 patients were pretreated with chemotherapy, and 5 patients were treatment-naïve. The median number of pulmonary metastases resected was 89 metastases per patient (range 27 to 249). Median overall survival (OS) was 9.9 years, and the 5-year survival rate (5YSR) was 77%. The laser resection technique enabled extensive removal of metastatic lesions while preserving healthy lung tissue, crucial for maintaining pulmonary function. The majority of patients experienced significant disease-free survival. A total of 43 operations were performed, of which 13 (30%) involved complications. Severe complications occurred after 4 operations (9%). The 90-day mortality was 0%.
Conclusions
High-intensity pulmonary metastasectomy for ASPS patients can be performed with low morbidity and no perioperative mortality. The technique preserves lung tissue, achieving a median OS of 9.9 years and 5YSR of 77%. These results highlight the potential benefits of surgical intervention in this challenging condition.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.