Prognostic factors and long-term results of pulmonary metastasectomy for pediatric histologies☆

Tronc, François; Conter, Cécile Faure; Marec‐Bérard, Perrine; Bossard, Nadine; Remontet, Laurent; Orsini, Alessandro; Gamondes, J. P.; Louis, Dominique

doi:10.1016/j.ejcts.2008.07.039

Cited by 42 publications

(28 citation statements)

References 23 publications

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“…Identifying a pulmonary nodule as malignant or benign is essential for accurate staging, selecting the appropriate treatment and determining prognosis (3-5). The prognosis of children with sarcoma has improved due to better staging, use of neoadjuvant chemotherapy and aggressive surgical resection of all suspected disease (6-8).…”

Section: Introductionmentioning

confidence: 99%

Do characteristics of pulmonary nodules on computed tomography in children with known osteosarcoma help distinguish whether the nodules are malignant or benign?

Brader

Abramson

Price

et al. 2011

Journal of Pediatric Surgery

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Purpose To determine if selected computed tomography (CT) characteristics of pulmonary nodules in pediatric patients with osteosarcoma can help distinguish the nodules as benign or malignant. Methods The institutional review board approved this HIPAA-compliant, retrospective study of 30 pediatric osteosarcoma patients (median age 14 years, range 8-22) who underwent chest CT with resection of 117 pulmonary nodules from January 2001 to December 2006. Two pediatric radiologists and one chest radiologist independently and retrospectively reviewed the CT scans and classified nodules as benign, malignant, or indeterminate on the basis of nodule size, laterality, number, location, growth, density, margin appearance and calcification. Generalized estimating equations were used to examine which characteristics were independent predictors of nodule malignancy. Results Of the 117 nodules, 80 (68%) were malignant and 37 (32%) were benign by pathologic review. The readers correctly classified 93-94% of the malignant nodules. For benign lesions, the results were not as accurate, with the readers correctly classifying only 11-30% of lesions. The majority of benign lesions were classified as indeterminate by the readers (54-65%). Nodule size (≥ 5 mm) and the presence of calcifications were associated with an increased probability of malignancy (p<0.05). Conclusion On chest CT, nodule size ≥ 5 mm and the presence of calcifications are associated with an increased probability of malignant nodule histology in pediatric patients with osteosarcoma. However, nodule characteristics, apart from size and calcification, at chest CT cannot reliably distinguish benign from malignant pulmonary nodules in these patients.

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Section: Introductionmentioning

confidence: 99%

Do characteristics of pulmonary nodules on computed tomography in children with known osteosarcoma help distinguish whether the nodules are malignant or benign?

Brader

Abramson

Price

et al. 2011

Journal of Pediatric Surgery

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“…Resection of pulmonary metastases has shown to improve survival in some pediatric patients with solid tumors [1][2][3][4][5][6][7]. Although resection by bilateral staged thoracotomies is commonly recommended, several other surgical approaches have been described, including thoracoscopic surgery, bilateral simultaneous thoracotomy, and median sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…In a select group of children with solid tumors and bilateral pulmonary metastases, primary resection of these nodules may increase survival [1][2][3][4][5][6][7]. Although the prognosis of these patients has improved, survival of patients with pulmonary metastases ranges between 20% and 50% at 5 years [1,7].…”

mentioning

confidence: 99%

Median sternotomy for bilateral pulmonary metastasectomy in children

Tsai

Mattei

2012

Journal of Pediatric Surgery

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“…Because of the survival advantage conferred by complete resection of pulmonary metastases in selected pediatric malignancies (Tronc et al 2008) and the difficulty in reliably diagnosing metastatic disease solely by imaging when only one or a few small lung nodules are discovered in a child with a solid tumor, there is a trend toward resecting or performing a biopsy of indeterminate pulmonary nodules. Fine needle aspiration cytology is widely practiced in adult patients with carcinoma and is usually diagnostic.…”

Section: Pulmonary Metastasesmentioning

confidence: 99%