The prognosis of bone and soft tissue sarcomas with clinically detectable metastasis at initial presentation (M1 cases) is commonly poor. This study examined the clinical course and outcome of 10 M1 patients diagnosed between 1989 and 2002 at Tottori University and National Yonago Hospital. The patients included 7 males and 3 females, aged 11-87 years (median, 37.8). They were diagnosed with osteosarcoma in 2 cases, malignant fibrous histiocytoma in 3 cases, leiomyosarcoma in 2 cases, and 1 case each of rhabdomyosarcoma, epithelioid sarcoma, and extraskeletal Ewing sarcoma. The metastatic sites at initial presentation were lungs in 6 cases, lymph nodes in 4 cases, bones in 3 cases, and skin in one case. Eight patients received surgical treatment for the primary lesion and five of them for the metastatic lesion. In 4 who underwent complete resection of the primary and metastatic lesions after chemotherapy, 2 of them are free of disease and 1 is alive with disease. The 2-year survival rate was 20.6%. These findings suggest that the combination of aggressive surgery for primary and metastastatic sites and chemotherapy can improve the prognosis for patients with bone and soft tissue sarcomas including clinically detectable metastasis at initial presentation.
