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Ann Thorac Surg 2005;80:1847-1852
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

Pulmonary Resection for Metastatic Malignant Fibrous Histiocytoma: An Analysis of Prognostic Factors

^a Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
^b Section of Biostatistics, Mayo Clinic College of Medicine, Rochester, Minnesota

Accepted for publication May 9, 2005.

^_* Address correspondence to Dr Deschamps, Division of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, 200 First St SW, Rochester, MN 55905 (Email: deschamps.claude{at}mayo.edu).

Presented at the Poster Session of the Forty-first Annual Meeting of The Society of Thoracic Surgeons, Tampa, FL, Jan 24–26, 2005.

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.

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