Prognostic factors of pulmonary metastasectomy for osteosarcomas of the extremities

Abstract

Current practice of pulmonary metastasectomy for osteosarcomas in our institution was well justified. The number of pulmonary metastases more than five and the advent of pulmonary metastases during pre- and postoperative chemotherapy seemed relevant to a worse prognosis.

Metastasectomy of Pulmonary Metastases from Osteosarcoma: Prognostic Factors and Indication for Repeat Metastasectomy

“…Some reports show that there was no difference in survival between younger and older people [1,3,5,8]. But our results show that patients aged > 15 years had a better prognosis than patients aged ≤ 15 years.…”

“…In a previous systematic review of reported outcome in approximately 1,800 osteosarcoma patients with pulmonary metastases from 1939 to 2007, the main prognostic factor affecting survival was found to be complete surgical remission [1,[4][5][6]8]. In addition, DFI, as well as number and localization of metastases, has also been found to be significantly associated with survival [3,[5][6][7][9][10][11].…”

“…The number of metastases has been a matter of interest since the study by Putnam et al who described an association between decreased survival and more than three metastases on preoperative CT [12]. However, most studies do not describe how the cut-off point for the number of nodules was determined, and therefore cut-offs range between "more than one" and "six nodules or more" [1][2][3][5][6][7][8].…”

“…The long-term survival of patients with osteosarcoma has dramatically improved with the use of combination chemotherapy, local treatment, and aggressive metastasectomy [1,2]. Approximately 50% of patients with osteosarcoma develop synchronous or metachronous metastatic lung disease [3]. The prognosis of patients with synchronous or metachronous metastatic osteosarcoma has improved over the last two decades, with the 5-year disease-free survival rate increasing from 0-17% to 30-50% [4].…”

Outcome of Radical Surgery for Pulmonary Metastatic Osteosarcoma with Secondary Spontaneous Pneumothorax: Case Series Report

“…[6][7][8][9][10] To date, various parameters, including long DFI, completeness of resection, timing of metastases, limited number of pulmonary nodules (<4), tumor size, and laterality of metastases have been reported as prognostic factors in first metastasectomy. [10][11][12][13] Meanwhile, Jeffrey reported that less than 10% of patients with SSP following sarcoma lived more than 2 years after the initial pneumothorax diagnosis. The poor prognosis had shown clinically progressive activity of malignant tumors with SSP of sarcoma, and SSP may be associated with increased mortality, except for Ewing sarcoma, Wilm's tumor, and rhabdomyosarcoma.…”