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We identified prognostic factors in a 30-year series of STS treated at a single Institution, using an advanced statistical approach. From June 1988 to July 2019, 164 patients were referred to Rizzoli Orthopedic Hospital, Bologna, Italy) for STS lung metastasectomy (LMTS). The endpoints were lung metastasis recurrence (LMR) and lung metastasis-specific mortality (LMSM). The analysis included directed acyclic graphs, cubic splines, and a competing risk model in order to minimize bias. The 10- and 15- year LMR cumulative incidence were 0.77