Surgical management and outcome of osteosarcoma patients with unilateral pulmonary metastases Journal Article
| Authors: | Su, W. T.; Chewning, J.; Abramson, S.; Rosen, N.; Gholizadeh, M.; Healey, J.; Meyers, P.; La Quaglia, M. P.; Martinez, L.; Geiger, J.; Shochat, S.; Stein, J.; McGahren, E. |
| Article Title: | Surgical management and outcome of osteosarcoma patients with unilateral pulmonary metastases |
| Abstract: | Purpose: The surgical management of osteosarcoma patients with unilateral pulmonary nodules is controversial. The authors reviewed their institutional experience to evaluate the incidence of occult contralateral metastases. Methods: Data were obtained retrospectively on all consecutive osteosarcoma patients from 1980 to 2002. Eighty-four patients with pulmonary nodules were identified. Forty-one had bilateral disease, and 43 had unilateral involvement by computed tomography (CT) scan. Results: All 43 patients with unilateral nodules underwent ipsilateral thoracotomies. Fifteen patients had negative exploration findings, and only 1 had pulmonary relapse. Of the 28 patients with metastases confirmed at initial thoracotomies, 14 had extensive pleural or extrapulmonary disease at initial thoracotomy followed by disease progression. The other 14 are separated into early versus late metastases, using 2 years from diagnosis as the cutoff point. Seven of the 9 (78%) patients with early metastases had or subsequently had contralateral disease; 6 were identified at staged contralateral thoracotomy and 1 had relapsed in the unexplored lung a year later. Only 1 of the 5 patients with late unilateral metastases had relapse in the contralateral side. Conclusions: Our data indicate that there is a high rate of contralateral involvement in osteosarcoma patients with unilateral nodules diagnosed by CT scan. Staged bilateral thoracotomies should be considered in osteosarcoma patients presenting with unilateral pulmonary disease on imaging studies within 2 years of diagnosis. © 2004 Elsevier Inc. All rights reserved. |
| Keywords: | osteosarcoma; adolescent; adult; child; clinical article; controlled study; bone neoplasms; child, preschool; cancer surgery; retrospective studies; disease course; cancer recurrence; conference paper; computer assisted tomography; thoracotomy; lung neoplasms; tomography, x-ray computed; lung metastasis; metastasectomy; lung nodule; pleura disease; pulmonary metastases; humans; human; male; female; priority journal |
| Journal Title: | Journal of Pediatric Surgery |
| Volume: | 39 |
| Issue: | 3 |
| ISSN: | 0022-3468 |
| Publisher: | W.B. Saunders Co-Elsevier Inc. |
| Date Published: | 2004-03-01 |
| Start Page: | 418 |
| End Page: | 423 |
| Language: | English |
| DOI: | 10.1016/j.jpedsurg.2003.11.030 |
| PROVIDER: | scopus |
| PUBMED: | 15017563 |
| DOI/URL: | |
| Notes: | Presented at the 34th Annual Meeting of the American Pediatric Surgical Association; 2003 May 25-28; Fort Lauderdale, FL -- Cited By (since 1996):31 -- Export Date: 16 June 2014 -- CODEN: JPDSA -- Source: Scopus |
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