Outcome of a pulmonary metastasectomy for an orthopedic malignancy

The purpose of this study was to examine the pulmonary metastatic results in patients with orthopedic malignancies. Forty-three consecutive patients who underwent a resection of a pulmonary metastasis from an orthopedic malignancy in our hospital were retrospectively investigated. The survival following the resection of a pulmonary metastatic tumor was then analyzed using the Kaplan-Meier method. The impact of clinicopathologic variables on the prognosis including gender, patient age, primary tumor type, the number of the pulmonary metastases, the number of metastasectomies, the operation-era, and the disease-free interval was examined by the Logrank test and Cox's proportional hazards model. The 5-year overall survivals after a pulmonary metastasectomy were 20.7%. A univariate analysis revealed a significant benefit in the post-metastasectomy survival based on the patients age and the disease-free interval. A multivariate analysis demonstrated patient age to be an independent factor for the prognosis with a hazard ratio of 4.873 (p = 0.0373). When only young (less than 40 years of age) patients were investigated, the histologic type was revealed to be related to the prognosis (p = 0.0004). Pulmonary metastasis from soft tissue tumors is considered to lead to a poor prognosis for younger patients and a metastasectomy for such patients should be considered as one of the potentially effective treatments.