Five-year overall survival is substantially higher after pulmonary metastasectomy for STS in our study relative to previously published results (52% versus 14-40%). This improvement does not seem to be the result of greater use of, or newer, chemotherapeutic regimens. Among potential explanations, improved patient selection is the most likely factor.
Despite higher rates of hypertension, higher American Society of Anesthesiologists status, higher body mass index, and higher rates of blood transfusion, the 65 years and older group had outcomes equal to those of the general population. Thus, free flap breast reconstruction in patients of advanced age is safe, and should be offered when indicated.
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