Patterns of recurrence after resection of osteosarcoma of the extremity. Strategies for treatment of metastases
J. F. Huth and F. R. Eilber
Department of Surgery, UCLA School of Medicine.
We studied recurrence patterns in 255 patients with high-grade osteosarcoma
of the extremity and the efficacy of the treatment of these recurrences.
One hundred seven patients developed metastatic disease: 77 had isolated
pulmonary metastases, 17 had simultaneous metastases to lung and elsewhere,
and 13 had metastases to other sites. Of the 77 patients with metastases
confined to the lung, 51 (66%) underwent thoracotomy for resection of the
metastases, and 13 (17%) are long-term disease-free survivors. Patients
with simultaneous metastases to lung and other sites, and patients with
metastases to sites other than lung, have a poor prognosis with only one
long-term disease-free survivor in these groups. Thoracotomy has a limited
role in the treatment of metastatic disease. Improvements in aggressive,
systemic chemotherapy are essential for improving the prognosis in these
patients.