Clinical Outcome in Soft Tissue Sarcoma Patients with Lung Metastasis Who Received Metastasectomy and/or Radiofrequency Ablation: Tokai Musculoskeletal Oncology Consortium Study

Figures & data

Table 1 Patients’ Characteristics

Age (Years)	Mean (Range)	59 (16–87)
Sex	Male	65
	Female	27
Surgical resection at primary site	Yes	89
	No	3
Lung metastasis at initial presentation	Yes	10
	No	82
Distribution at lung metastasis	Unilateral	59
	Bilateral	31
	Unknown	2
Maximum metastasis size (mm)	Mean (range)	14.6 (3–56)
Number of metastases	Single	41
	2–4	34
	5–9	6
	>10	11
Perioperative chemotherapy	Yes	34
	No	58
Extrapulmonary metastasis	Yes	9
	No	83
DFI (months)	Mean (range)	18 (0–104)

Abbreviation: DFI, disease-free interval.

Table 2 Patient Backgrounds According to Treatment

Group		Surgery	Surgery+RFA	RFA	P value
		(n=61)	(n=9)	(n=13)
3Y DSS		66%	66.7%	59.2%	0.39
Age	Median (years)	60	60	66	0.74
Sex	Male	52	4	9
	Female	18	5	4	0.2
Histology	UPS	21	2	0
	LMS	12	3	7
	MPNST	11	0	1
	SS	6	1	1
	MFS	3	3	1
	Other	17	0	3
Size	Median (mm)	12	15	16	0.72
Distribution	Unilateral	51	5	4	0.008
	Bilateral	18	4	9
Number	Single	36	4	1	0.01
	Multiple	34	5	12
Curability	Complete	61	9	4	<0.001
	Incomplete	9	0	9

Abbreviations: 3Y DSS, 3-year disease-specific survival; LMS, leiomyosarcoma; MFS, myxofibrosarcoma; MPNST, malignant peripheral nerve sheath tumor; RFA, radiofrequency ablation; SS, synovial sarcoma; UPS, undifferentiated pleomorphic sarcoma.

Table 3 Possible Variables for Curability

Variable		Curability		P value
		Complete	Incomplete
Age (years)	Median	59.5	66	0.31
Sex	Male	50	15
	Female	24	3	0.25
Lung metastasis at presentation	Yes	3	7
	No	71	11	0.0003
Distribution	Unilateral	54	5
	Bilateral	19	12	0.001
Max. size (mm)	Median	11.5	17	0.03
Number	Single	41	0
	Multiple	33	18	<0.0001
Perioperative chemotherapy	Yes	27	7
	No	47	11	1
DFI (months)	Median	14.8	3	<0.0001
DFI, disease-free interval

Figure 1 Kaplan–Meier curves showing the post-metastatic survival of 92 patients with soft tissue sarcoma after initial lung metastasis.

Figure 2 Kaplan–Meier curves showing post-metastatic survival according to the curability of the initial lung metastasis (A: complete treatment, B: incomplete treatment).

Table 4 Univariate Analysis for Predicting Post-Metastatic Survival

Variable		N	Post-Metastatic Survival (%)				P value
			3Y	95% CI	5Y	95% CI
Age (years)	>70	23	64.5	41.3–80.4	58	34.1–75.9
	<70	51	71.2	56.2–81.8	59.1	43.4–71.8	0.51
Sex	Male	50	68.5	53.2–79.7	58.1	42.2–71.1
	Female	24	69.9	46.9–84.4	58.7	34.9–76.3	0.996
Metastasis (number)	1	41	80	63.9–89.5	73.4	55.9–84.9
	>1	33	55.3	36.5–70.7	40.1	22.4–57.2	0.01
	1–2	60	70.8	57.2–80.7	64.1	49.8–75.3
	>2	14	61.9	31.2–82.1	36.1	11.8–61.5	0.27
Size (mm)	>11.5	36	56.3	38.2–71	38.1	21.2–54.8
	<11.5	36	80	62.5–89.9	76.4	58–87.5	0.004
Distribution	Unilateral	55	72.1	58–82.2	62.4	47.2–74.3
	Bilateral	19	59.6	33.3–78.4	47	22.6–68.2	0.57
Perioperative chemotherapy	Yes	27	72.2	50.4–85.7	58.9	36.9–75.5
	No	47	67.5	52–79	58.7	42.2–71.9	0.43
Treatment	Surgery alone	61	69.3	55.7–79.4	58.3	43.8–70.2
	RFA ± surgery	13	66.7	33.7–86	58.3	27–80.1	0.85

Abbreviations: 95% CI, 95% confidential interval; RFA, radiofrequency ablation; Y, year.

Table 5 Multivariate Analysis for Predicting Post-Metastatic Survival

Variable		HR	95% CI	P value
Size	mm	1.044	1.013–1.077	0.0006
Number	Multiple	1
	Single	0.4075	0.1882–0.8823	0.02

Abbreviations: 95% CI, 95% confidential interval; HR, hazard risk.

Table 6 Post-Metastatic Survival According to Lung Condition

Group		Post-Metastatic Survival (%)
	n	3Y	95% CI	5Y	95% CI
A	21	89.9	65.3–97.4	89.9	65.3–97.4
B	15	66.7	37.5–84.6	58.3	29.3–78.9
C	19	67.7	41.6–84	53.3	27.1–73.8
D	17	44.1	20.7–65.9	22.7	5.96–45.8

Notes: A, single and small (<11.5 mm); B, multiple and small; C, single and large (>11.5 mm); D, multiple and large.

Figure 3 Kaplan–Meier curves showing the post-metastatic survival of 72 patients according to the curability of the initial lung metastasis (A: single and smaller [<11.5 mm]; B: multiple and smaller [<11.5 mm], C; single and larger [>11.5 mm], D; multiple and larger [>11.5 mm]).