(P 091) THE PROGNOSIS OF PULMONARY METASTASIS AFTER THE SURGERY FOR PRIMARY LESION IN ELDERLY HIGH-GRADE SARCOMA PATIENTS

Objective: Surgical treatment and chemotherapy for the pulmonary metastasis of bone and soft tissue sarcoma are reported to improve survival of patients. However, there are few studies to reveal the standard treatment for elderly people with pulmonary metastasis. This study aimed to analyze the overall survival and the clinical outcome of the elderly high-grade sarcoma patients with pulmonary metastasis after the surgery for primary lesion.

Methods: Between 2010 and 2020, 85 patients over 70 years old with high-grade bone and soft tissue sarcoma without any metastasis underwent surgical treatment in our hospital. Of those, 20 patients who had pulmonary metastasis following the surgery were included in this study. Overall survival (OS) was retrospectively analyzed by the Kaplan-Meier method, and the difference of OS according to treatment methods was analyzed using Log-rank test.

Results: This study group consisted of 11 males and 9 females. The mean age was 77 years (71-87). The mean period from surgery for primary sarcoma to pulmonary metastasis was 10 months (2-56). The mean period of follow-up after pulmonary metastasis was 17 months (3-65). Considering the pathological diagnosis of the tumors, undifferentiated pleomorphic sarcoma was the most common with six cases. The treatments for the primary sarcoma were surgery in 15 cases and surgery with adjuvant radiotherapy in five cases. The treatments for pulmonary metastasis were local treatment in five cases including surgery in four cases and cyberknife in one case, chemotherapy in 10 cases and no further treatments in five cases. After pulmonary metastasis, 1-year OS was 61.5% and 2-year OS was 41.9%. 1-year OS in local treatment group was 80.0%, 55.6% in chemotherapy group, and 55.3% in no treatments group. There were no significant differences in OS with or without local treatment or chemotherapy. (Log-rank; p=0.567, p=0.526)

Conclusion: In this study, we revealed the OS rate following pulmonary metastasis. OS in local treatment group was higher than other groups as previous study although there were no significant differences. On the other hand, there was not much difference between chemotherapy group and no treatment group. This fact may indicate that the chemotherapy does not increase survival for elderly people with pulmonary metastasis.