Pulmonary metastases from osteogenic sarcoma: Complete resection and effective chemotherapy contributing to improved prognosis

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Abstract
Of 54 unselected patients with osteogenic sarcoma metastatic to the lung who were entered into two successive prospective studies in Western Germany and Austria, 16 presented with synchronous pulmonary metastases (PM) and primary rumor and 38 developed PM during or after chemotherapy. Eleven out of 29 patients (37.9%) undergoing one or more thoracotomies survived, for an actuarial three-year survival rate (SR) of 29%, in contrast to only one out of 21 patients without pulmonary surgery. After complete resection of pulmonary lesions, the SR was significantly higher than after incomplete resection (p < 0.01). We could not demonstrate a significant association between the number of pulmonary metastases resected and SR. Of the patients undergoing complete resection, those with synchronous PM and primary tumor had an insignificantly higher SR than those with metachronous PM. Five out of eight patients whose PM contained no or only small foci of viable tumor survived with no evidence of disease in contrast to only 3 out of 17 whose PM contained large areas of viable tumor (p = 0.035), thus demonstrating that effective chemotherapy is capable of improving the prognosis in osteogenic sarcoma metastatic to the lung.