TY - JOUR
T1 - Pulmonary resection for metastatic malignant fibrous histiocytoma
T2 - An analysis of prognostic factors
AU - Suri, Rakesh M.
AU - Deschamps, Claude
AU - Cassivi, Stephen D.
AU - Nichols, Francis C.
AU - Allen, Mark S.
AU - Schleck, Cathy D.
AU - Pairolero, Peter C.
PY - 2005/11
Y1 - 2005/11
N2 - Background. Factors affecting recurrence and survival after pulmonary resection for metastatic malignant fibrous histiocytoma (MFH) are not well known. Methods. Records of patients undergoing pulmonary metastasectomy for MFH between January 1976 and January 2000 were analyzed. Results. There were 103 patients (46 men and 57 women). Median age was 60 years (range, 20 to 86). Malignant fibrous histiocytoma metastasis was solitary in 29 patients (28%), multiple/unilateral in 33 (32%), and multiple/bilateral in 41 (40%). Median time interval from primary tumor resection to metastasectomy was 11 months (range, 0 to 86). Wedge resection was carried out in 87 patients (84%), segmentectomy in 3 (3%), lobectomy in 3 (3%), pneumonectomy in 2 (2%), and a combination of resections in 8 (8%). Resection was complete in 93 patients (90%). Complications occurred in 11 patients (11%) and included prolonged air leak in 7, and pneumonia, empyema, atelectasis, and sepsis in 1 each. One patient died (operative mortality, 1%). Follow-up ranged from 2 weeks to 153 months (median, 18 months). Five-year survival was 21% (95% confidence interval, 14% to 31%). In the 103 patients, incomplete resection (p < 0.0001) was associated with decreased survival. Among the 93 patients with complete resection, factors associated with decreased survival included the presence of extrapulmonary disease at time of metastasectomy (p = 0.01), more than two nodules resected (p = 0.001), and adjuvant therapy after metastasectomy (p = 0.0007). Conclusions. Pulmonary resection of metastatic MFH is safe. Improved survival was associated with the absence of extrapulmonary disease at time of metastasectomy, with fewer than three pulmonary nodules resected, and with a complete resection.
AB - Background. Factors affecting recurrence and survival after pulmonary resection for metastatic malignant fibrous histiocytoma (MFH) are not well known. Methods. Records of patients undergoing pulmonary metastasectomy for MFH between January 1976 and January 2000 were analyzed. Results. There were 103 patients (46 men and 57 women). Median age was 60 years (range, 20 to 86). Malignant fibrous histiocytoma metastasis was solitary in 29 patients (28%), multiple/unilateral in 33 (32%), and multiple/bilateral in 41 (40%). Median time interval from primary tumor resection to metastasectomy was 11 months (range, 0 to 86). Wedge resection was carried out in 87 patients (84%), segmentectomy in 3 (3%), lobectomy in 3 (3%), pneumonectomy in 2 (2%), and a combination of resections in 8 (8%). Resection was complete in 93 patients (90%). Complications occurred in 11 patients (11%) and included prolonged air leak in 7, and pneumonia, empyema, atelectasis, and sepsis in 1 each. One patient died (operative mortality, 1%). Follow-up ranged from 2 weeks to 153 months (median, 18 months). Five-year survival was 21% (95% confidence interval, 14% to 31%). In the 103 patients, incomplete resection (p < 0.0001) was associated with decreased survival. Among the 93 patients with complete resection, factors associated with decreased survival included the presence of extrapulmonary disease at time of metastasectomy (p = 0.01), more than two nodules resected (p = 0.001), and adjuvant therapy after metastasectomy (p = 0.0007). Conclusions. Pulmonary resection of metastatic MFH is safe. Improved survival was associated with the absence of extrapulmonary disease at time of metastasectomy, with fewer than three pulmonary nodules resected, and with a complete resection.
UR - http://www.scopus.com/inward/record.url?scp=26844527319&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=26844527319&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2005.05.004
DO - 10.1016/j.athoracsur.2005.05.004
M3 - Article
C2 - 16242467
AN - SCOPUS:26844527319
SN - 0003-4975
VL - 80
SP - 1847
EP - 1852
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -