Akademik Veri Yönetim Sistemi
General Thoracic and Cardiovascular Surgery, 2026 (SCI-Expanded, Scopus)
Objectives: Pulmonary metastasectomy is considered the local treatment in selected patients, as it improves long-term survival. This study aims to investigate the prognostic factors of pulmonary metastasectomy for recurrence-free survival (RFS) and overall survival (OS). Methods: A retrospective evaluation was conducted of those who underwent pulmonary metastasectomy between 2011 and 2021 in a tertiary referral center. Variables were screened using univariable and multivariable Cox regression analysis. Prognostic nomogram models were constructed using the multivariable Cox analysis results to determine 5-year RFS and OS probabilities. Results: The study cohort included 159 patients. The median follow-up period was 45 months. 5-year RFS was 27.7%, and OS was 50.4%. Largest tumor size ≥ 15 mm was statistically significant prognostic factor for RFS (hazard ratio HR: 1.583; p = 0.031) in the univariable analysis. The total sum of tumor size ≥ 15 mm emerged as the strongest adverse prognostic factor for RFS (HR, 2.440; p < 0.001) and OS (HR, 1.870; p = 0.038) in the multivariable analysis. Patients with a disease-free interval (DFI) ≤ 24 months had significantly shorter RFS (HR: 2.965; p < 0.001) and OS (HR: 2.280; p < 0.001) in the multivariable analysis. Conclusion: In patients with a primary histology of sarcoma, more than five metastatic nodules, the total sum of tumor size ≥ 15 mm, and a DFI of less than two years, metastasectomy should be considered with caution. Furthermore, when planning surgery for multiple metastases, whether a negative surgical margin can be achieved for each lesion should be carefully considered. The possible candidates for re-metastasectomy surgery should be selected with caution.