V-190 Grading of metastases is a prognostic factor for survival after pulmonary metastasectomy for leiomyosarcoma

Hintergrund

Survival in patients with metastatic leiomyosarcoma is still poor, with 5-year survival of about 20%. Chemotherapeutic options are limited. Pulmonary metastasectomy (PM) is an established treatment option in patients with isolated lung metastases. Here we focused on patients with leiomyosarcoma undergoing PM. Outcome and potential clinical prognostic factors were assessed.

 

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Material und Methode

We retrospectively reviewed data from all patients who underwent PM for leiomyosarcoma in our center from 2004 to 2019. Survival was calculated from the date of PM until last follow-up. Univariate analysis was performed to study the impact on overall survival (OS) and progression-free survival (PFS) of the following variables: site of the primary sarcoma, sizes of metastasis and primary tumor, grading, timing of occurrence of pulmonary metastasis, number of metastasis, repeat PM.

 

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Ergebnis

40 patients (21 females, 53%) were included. Median age at diagnosis of primary sarcoma was 49 years (19 to 82). Median time from diagnosis of primary sarcoma and diagnosis of pulmonary metastases was 25 months (0 to 242). Uterine leiomyosarcoma was the most common histology (n=13, 32.5%). Thoracotomy was performed in 37 (93%) patients. The median number of resected metastases was 2 (1 to 34). The median size of resected metastases was 16.5mm (3 to 70). Lymph node sampling was performed in 22 (55%) patients. Fourteen (35%) patients underwent repeat PM. 90-day mortality was 0%. Three and 5-year OS were 84% and 59%, respectively. Patients with high-grade (G2/3) metastases had significantly worse median OS (67 vs 102 months, p=0.05) as well as a trend for worse median PFS (6 vs. 44 months, p=0.052) compared to patients with G1 metastases. Patients with recurrent isolated lung metastases who underwent re-PM had a trend for better OS compared to those who did not undergo re-PM (108 vs. 66 months, p=0.124).

 

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Schlussfolgerung

Patients showed encouraging long-term outcome after PM for lung metastatic leiomyosarcoma. Grading of metastases is a significant prognostic factor for OS.

 

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Publication History

Article published online:
06 September 2021