Metastases & Chemotherapy

<b>If the pulmonary metastases are operable, but there are other tumor deposits which are inoperable.....
Or if the pulmonary metastases are inoperable and not ablatable....
Then systemic chemotherapy might be the treatment of choice.</b>

For further discussion of chemotherapy and chemotherapy agents, see the &&url of this website. 

<b>Pulmonary Metastases & Chemotherapy 
Selected Medical Journal Annotated References </b>


Gan To Kagaku Ryoho 1998 Sep;25(11):1701-6 
<b>[Chemotherapy for pulmonary metastases of soft tissue sarcoma]. [Article in Japanese]</b> 
Kito M, Umeda T. 
Dept. of Orthopedic Surgery, National Cancer Center Hospital East. 

The role and value of chemotherapy for soft tissue sarcomas remain unclear. Seventeen patients with pulmonary metastatic soft tissue sarcomas underwent treatment with chemotherapy, and the clinical efficacy and prognosis were studied. ... [3 patients had LMS] The chemotherapy agents were ifosfamide in 10 cases, combination of ifosfamide and adriamycin in 5 cases, or cisplatin and adriamycin in 2 cases. Of the 17 patients, seven had partial responses radiographically and five had pulmonary metastases from synovial sarcoma. Eight patients underwent resection of pulmonary metastases following chemotherapy.... Twelve of the patients died of disease at 6-108 months (median, 30 months) from the time of the initial therapy, and five patients have survived from 1-53 months (median, 30 months). <b>The absolute three-year survival rate, ..., for all 17 patients was 39%. In the two cases with no change and progressive disease, all patients were dead within 2 years, while in the seven partial response cases, two patients were dead, four were alive with pulmonary metastases, and only one case was disease-free at this writing. The survival rate for patients with partial response was significantly higher than for patients with no response. </b>  Although the cure rate of pulmonary metastatic soft tissue sarcomas is still low, <b>the combination of chemotherapy and surgery has been shown to result in prolonged survival.</b>  
&&url PMID: 9757195   

J Surg Oncol 1993 May;53(1):54-9 
<b>Selected benefits of thoracotomy and chemotherapy for sarcoma metastatic to the lung.</b> 
Mentzer SJ, Antman KH, Attinger C, Shemin R, Corson JM, Sugarbaker DJ. 
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115. 

To determine the benefit of aggressive surgical therapy, we studied 77 consecutive patients presenting to our sarcoma registry with pulmonary metastases. Detailed follow-up was available on all patients; the median follow-up of the 13 long-term survivors was 72 months from the date of diagnosis of the primary tumor. <b>Survival of these 77 patients with metastatic disease was independent of the size, location, and histology of the primary tumor. Once metastases developed, survival of patients with pulmonary metastases was not influenced by the extent of surgical resection of the primary tumor or by the use of radiation therapy. 

Pulmonary metastases were initially treated with thoracotomy and metastasectomy in 34 patients. The median survival after thoracotomy was 26 months. Seven patients were alive more than 4 years after their diagnosis. Pulmonary metastases were treated with chemotherapy alone in 43 patients. Although the survival was shorter (median survival 14 months) in patients treated with chemotherapy, an objective response to chemotherapy was obtained in 13 (30%) patients. Four of these patients were alive 4 years after their diagnosis. These data demonstrate that both thoracotomy and chemotherapy are associated with long-term survival of patients with sarcoma metastatic to the lung.</b> 
&&url PMID: 8479198 

