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STS Lung Metastasectomy — SCE Medical Oncology MCQ

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ModerateSarcomaSTS Lung MetastasectomySCE Medical Oncology

A 55-year-old woman with soft tissue sarcoma has an isolated lung metastasis detected on surveillance CT 2 years after completing adjuvant treatment for primary thigh leiomyosarcoma. What surgical approach may be curative?

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Correct answer: B — Pulmonary metastasectomy may be curative in selected STS patients — criteria: complete resection of all pulmonary disease technically feasible, controlled primary, no extrapulmonary disease, adequate respiratory reserve and prolonged disease-free interval

Pulmonary metastasectomy is an established curative-intent intervention for selected STS patients with lung-limited metastatic disease. Favourable prognostic factors: complete resection (R0), ≤3 lesions, prolonged disease-free interval (>12-18 months), absence of extrapulmonary disease, low-grade histology and good response to preoperative chemotherapy. Five-year OS after complete metastasectomy is approximately 30-40%. The International Registry of Lung Metastases provides the largest dataset supporting this approach.

Reference: ESMO 2024 STS; NICE; International Registry of Lung Metastases; Pastorino et al J Thorac Cardiovasc Surg 1997