APSA PaperLong-term survival after aggressive resection of pulmonary metastases among children and adolescents with osteosarcoma☆
Section snippets
Materials and methods
After obtaining institutional review board approval, a comprehensive search of the Tumor Registry database at the University of Texas MD Anderson Cancer Center was used to identify patients younger than 21 years with osteosarcoma metastatic to the lung. Patients with primary tumors of the head and neck, radiotherapy-induced osteosarcoma, or initial diagnosis and majority of treatment (defined as preoperative through postoperative chemotherapy) at outside institutions were excluded. Patients
Results
There were 272 patients with osteosarcoma of the trunk or extremities who were younger than 21 years and who had medical records available for review. Of these, 137 developed or presented with radiographically evident (on lung tomograms, chest x-ray, or computed tomographic scan) pulmonary nodules. These 137 patients formed the initial study cohort.
The median follow-up for the initial cohort was 2.5 years (5 days to 20.1 years). Overall survival at 3 and 5 years was 40.2% and 22.6%,
Discussion
Just 3 decades ago, the development of pulmonary metastases from osteosarcoma virtually ensured an early death [3], [17]. Advances in chemotherapeutic strategy and refinement of surgical indications and approaches have significantly improved the prognosis for these patients.
Two independent factors that were shown to predict long-term survival after pulmonary metastasectomy were the response of the primary tumor to preoperative chemotherapy and DFI. Primary tumor response to chemotherapy (or
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Presented at the 36th Annual Meeting of the American Pediatric Surgical Association, Phoenix, AZ, May 29-June 1, 2005.
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This study was supported in part by grants K23HD001473 and K24RR17050 from the National Institutes of Health, Bethesda, Md.