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January 1, 2012BMJ OpenOpen Access

Pulmonary metastasectomy for sarcoma: a systematic review of reported outcomes in the context of Thames Cancer Registry data

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Key result

Pulmonary metastasectomy for sarcoma yielded 5-year survival rates of 34% (bone) and 25% (soft tissue), higher than unselected registry data but without evidence of causal benefit.

Why the study?

Does surgical pulmonary metastasectomy improve survival in patients with sarcoma metastatic to the lungs compared to unselected registry data?

Population

1196 patients having one or more of 1357 pulmonary metastasectomy operations for sarcoma metastatic to the…

Comparison

Surgical pulmonary metastasectomy. vs Unselected registry data for patients with…

Design

Systematic_review

Follow-up

5 years

Authors

TTTom TreasureInterventional / Structural CardiologyFFFrancesca FiorentinoUniversity of LeedsMSMarco ScarciUniversidade da Coruña

Discussion

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Implication

Selected patients show higher post-metastasectomy survival than registry data; leaves open whether surgery improves outcomes beyond selection.

Study Design

Type

Systematic Review (n=1,196)

Multicenter

Yes

Structured PICO

Does surgical pulmonary metastasectomy improve survival in patients with sarcoma metastatic to the lungs compared to unselected registry data?

P
Population
1,196 patients undergoing pulmonary metastasectomy for sarcoma across 18 follow-up studies, with survival compared to unselected registry data.
I
Intervention
Surgical pulmonary metastasectomy (43% had subsequent metastasectomy).
C
Comparator
Unselected registry data (Thames Cancer Registry) for patients with metastatic sarcoma.
O
Outcome
Survival data to various time points, usually 5 years and sometimes 3 or 10 years.hard clinical

The higher 5-year survival rate among sarcoma patients selected for pulmonary metastasectomy compared to unselected registry data may be due to selection bias rather than the procedure itself, highlighting the need for better evidence.

Limitations

  • No evidence that survival difference is attributable to metastasectomy
  • No data on respiratory or any other symptomatic benefit
  • Certain harm associated with thoracotomy, often repeated
  • No symptomatic or quality of life data reported
  • Survival difference may be due to selection bias rather than metastasectomy

Cite This Study

Treasure et al. (2012) conducted a systematic review in Sarcoma with pulmonary metastases (n=1,196). Pulmonary metastasectomy vs. Unselected registry data (no metastasectomy) was evaluated on 5-year survival rate. Pulmonary metastasectomy for sarcoma yielded 5-year survival rates of 34% (bone) and 25% (soft tissue), higher than unselected registry data but without evidence of causal benefit.

synapsesocial.com/papers/6a3fa3244a2d33c351cd3ce1https://doi.org/10.1136/bmjopen-2012-001736
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Long-term results after resection for soft tissue sarcoma pulmonary metastases2009 · 41 citations
  2. 2Which Soft Tissue Sarcoma Patients with Lung Metastases Shouldnot Undergo Pulmonary Resection?2002 · 10 citations
  3. 3Efficacy of pulmonary metastasectomy for recurrent soft tissue sarcoma1991 · 53 citations
  4. 4Video-assisted versus open pulmonary metastasectomy: the surgeon's finger or the radiologist's eye?☆2009 · 85 citations