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High-grade osteosarcoma of the extremities metastatic to the lung: Long-term results in 323 patients treated combining surgery and chemotherapy, 1985–2005
Surgical Oncology, 06/19/09

Briccoli A et al. - In a study of high-grade osteosarcoma of the extremities metastatic to the lung, it was concluded that in pts with recurrent resectable pulmonary metastases from high-grade osteosarcoma treated with adjuvant or neoadjuvant chemotherapy, thoracotomy should always be considered regardless of the number of previous lung relapses and the number of secondary pulmonary lesions.

• 323 pts, 88 with resectable lung metastases at diagnosis and 235 with localized disease at presentation who relapsed with lung metastases, were treated.

• 498 lung surgeries and 607 thoracotomies were performed.
• 5-yr overall survival was 37%.
• Final outcome was significantly related to presence or absence of metastasis, time of first relapse and presence of local recurrences.
• According to stage of disease, the rate of a 5-yr event-free survival (EFS) was 36% for pts with localized disease who later relapsed and 9% for pts with resectable lung metastases at presentation.
• There were no differences in EFS between pts who underwent 2 or 3 thoracotomies and pts who had 4 or 5 thoracotomies (7.5 vs 18.7%).

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