Combined chemotherapy and surgery for pulmonary metastases from osteogenic sarcoma Results of 10 years experience

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Abstract
Twenty-three patients presented with isolated pulmonary metastases fromosteogenic sarcoma following primary treatment by amputation or limbsalvage, combined with chemotherapy. The metastases were treated byconservative surgical excision combined with chemotherapy; surgicalexcision was repeated for recurrent pulmonary metastases, provided therewere none elsewhere. Six patients are alive and disease-free followingtheir initial surgery. Of the remaining 17, 10 had recurrence confined tothe lungs, and 7 developed extra-pulmonary metastases. The 10 with isolatedpulmonary metastases all had further thoracotomies but eventually 7 died,as did all those with extra-pulmonary metastases. There were in all 45operations, with 1 hospital death and 1 serious complication. Actuarialsurvival at 1, 3, 5 and 7 years was 87%, 45%, 39% and 31%, respectively. Inthe 10 patients who had recurrence of isolated pulmonary metastases,survival at 1 and 3 years was 70% and 34%.

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