Management of Primary Pulmonary Artery Sarcomas

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Presentation transcript:

Management of Primary Pulmonary Artery Sarcomas Shanda H. Blackmon, MD, MPH, David C. Rice, MMB, BCh, Arlene M. Correa, PhD, Reza Mehran, MD, Joe B. Putnam, MD, W. Roy Smythe, MD, Jon-Cecil Walkes, MD, Garrett L. Walsh, MD, Cesar Moran, MD, Harsh Singh, MD, Ara A. Vaporciyan, MD, Michael Reardon, MD The Annals of Thoracic Surgery Volume 87, Issue 3, Pages 977-984 (March 2009) DOI: 10.1016/j.athoracsur.2008.08.018 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diagnosis and treatment algorithm for patients who do not respond to initial anticoagulation, have atypical features on computed tomography (CT) scanning, or present with constitutional symptoms in addition to shortness of breath. (MRI = magnetic resonance imaging; PA = pulmonary artery.) The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (Panel a) A fluorodeoxyglucose-avid recurrent primary pulmonary artery sarcoma, (Panel b) A computed tomography scan and pathology specimen of pulmonary artery sarcoma. (Panel c) Recurrent tumor within lung parenchyma. (Panel d) Gadolinium-enhanced magnetic resonance image of a pulmonary artery sarcoma involving the trunk of the pulmonary artery and bilateral main pulmonary arteries. The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Five-year cumulative survival probability in the current case series of patients having no multimodality therapy (solid line) vs a combined series of historical control patients having multimodality therapy (dotted line). The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Five-year cumulative survival probability in the current case series (dotted line) vs a combined series (solid line) of all historical controls since 1990. The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Five-year cumulative survival probability in the current case series plus other historical cases undergoing resection (dotted line) in the past 17 years vs a combined series of historical controls (solid line) undergoing tumor debulking, palliative pneumonectomy, or thromboendarterectomy. The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Recommended schedule for primary pulmonary artery (PA) sarcoma postoperative evaluation. (CT = computed tomography; MRI = magnetic resonance imaging.) The Annals of Thoracic Surgery 2009 87, 977-984DOI: (10.1016/j.athoracsur.2008.08.018) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions