ABSTRACT
BACKGROUND: Several reports have shown a prolonged survival after surgical treatment of pulmonary metastases from soft tissue sarcomas. However, it is still unclear which prognostic factors predict a favorable outcome. Series are not comparable and the data are conflicting. Therefore, a multi-institutional study was undertaken to analyze prognostic factors in selecting patients for resection of pulmonary metastases from soft tissue sarcomas. METHODS: This report is a retrospective study of the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group. Two hundred fifty-five patients underwent complete resection of lung metastases from soft tissue sarcomas. Cases with chondrosarcoma and small round cell sarcomas like Ewing sarcoma were excluded. RESULTS: The 3 year and 5 year overall postmetastasectomy survival rates were 54% and 38%, respectively. The disease free postmetastasectomy survival rates were 42% and 35%, respectively. Analysis of prognostic factors for a more favorable outcome revealed disease free intervals of 2.5 years or more, following a resection with microscopically free margins, age less than 40 years, and Grade I and II tumors. These prognostic factors have an independent influence on overall survival, using a multivariate Cox regression model. CONCLUSIONS: Surgical excision of lung metastases from soft tissue sarcomas is well accepted and should be considered as a first line of treatment if preoperative evaluation indicates that complete clearance of the metastases is possible. Further investigation is needed before chemotherapy can be recommended as additional therapy.
Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Sarcoma/secondary , Sarcoma/surgery , Adolescent , Adult , Age Factors , Aged , Child , Disease-Free Survival , Follow-Up Studies , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Middle Aged , Neoplasm Metastasis , Prognosis , Proportional Hazards Models , Retrospective Studies , Sarcoma/mortality , Sarcoma/pathology , Survival Rate , Time Factors , Treatment OutcomeABSTRACT
Thirty-one primary breast cancer patients were evaluated by radioimmunolymphoscintigraphy (RILS) and ex vivo scintigraphy (EVS) following subcutaneous injection of human monoclonal antibody In-111-LiLo-16.88. Lymph nodes (370) were assessed by EVS, pathology and immunohistochemistry. The positive predictive value (EVS) for antigen positive nodes, metastatic and hyperplastic, was 90% in stages O-IIB, and the sensitivity and specificity for all stages were 60% and 80% respectively. Four EVS positive nodes with follicular hyperplasia contained micrometastases. RILS and EVS correlate well by the Spearman Rank test (R=0.87). These results suggest RILS may be clinically useful and selectively limit the extent of the surgical procedure.
ABSTRACT
Twenty patients undergoing gastrointestinal surgery were randomly allocated to receive either 1 or 2 g of ceftriaxone, a long half-life third generation cephalosporin, as a single dose intravenous prophylaxis on induction of anaesthesia. Plasma and tissue samples were taken 2 hours and analysed with an HPLC procedure. The results of plasma and tissue concentrations of ceftriaxone showed that 1 g dosage was enough for preventing the occurrence of postoperative sepsis. No adverse reaction or side-effects were recorded.
