Complete Resection of Metastatic Soft Tissue Sarcoma Associated With Improved Disease-specific Survival
Researchers attempted to determine factors associated with DSS after patients with metastatic disease undergo surgical resection.
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Complete disease resection predicts for improved disease-specific survival (DSS) among patients with primary metastatic soft tissue sarcoma (STS), according to a poster presentation at the Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting.1
Approximately 25% of patients with metastatic STS have metastases at diagnosis. It was previously unknown, however, whether complete surgical resection of primary tumors and metastases improves DSS in this patient population.
For this study, researchers attempted to determine factors associated with DSS in patients with metastatic disease who have had surgical resection. Of 168 patients who underwent complete resection at 1 of 8 institutions, 50% had lung metastases only, 35% had other metastases only, and 15% had lung and other metastases. The mean patient age was 54 years, most patients had primary disease located in the trunk or extremity and 70% of patients had high-grade disease.
Compared with debulking, the hazard ratio (HR) for DSS associated with complete resection was 0.55. Compared with patients with lung and other metastases, patients with isolated lung metastases had an HR for DSS of 0.41.
Patients with high-grade disease (HR, 2.30) or who underwent chemotherapy (HR, 1.74) had a worse DSS.
The best HR for DSS was observed among patients with lung metastases only who underwent curative-intent resection (HR vs patients with lung and other metastases, 0.36).
The authors concluded that “complete removal of all sites of disease and the presence of isolated lung metastases are associated with improved survival after resection, even when accounting for grade, [lymph node] status, and receipt of other therapy.”
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- Ethun CG, Cardona K, Maithel S, et al. Approach to primary soft tissue sarcomas with metastatic disease: defining a cohort for resection, an 8-institution study from the U.S. Sarcoma Collaborative. Poster presentation at: Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting. November 8-11, 2017; Maui, Hawaii.