Surgical treatment and chemotherapy for pulmonary metastases from osteosarcoma
K. A. Skinner, F. R. Eilber, E. C. Holmes, J. Eckardt and G. Rosen
Division of Surgical Oncology, UCLA School of Medicine 90024.
Between 1971 and 1991, 247 patients with stage I osteosarcoma were treated
at UCLA. Patients were treated in four sequential groups, with group 1
receiving surgery alone, and groups 2 through 4 receiving various adjuvant
chemotherapeutic regimens. The incidence of lung metastases in these
patients decreased from 92% (group 1) to 31% (group 4), while the
proportion of patients undergoing pulmonary resection increased (17% vs
82%). Overall 5-year survival rate among patients with pulmonary metastases
increased from 0 in group 1 to 41% (actuarial) in group 4. No clinical
factor correlated significantly with outcome using univariate analysis,
although there was a trend toward prolonged survival in those with longer
disease-free intervals. Adjuvant chemotherapy and resection of pulmonary
metastases have transformed a uniformly fatal condition into one with a
reasonable expectation of long-term survival.
