Location of pulmonary metastasis in pediatric osteosarcoma is predictive of outcome.

Abstract:

BACKGROUND:The 3-year survival after pulmonary metastasectomy for osteosarcoma (OS) is approximately 30%. Resection of metastatic disease can prolong life in pediatric patients with OS. Our objective is to assess the outcome of pediatric patients with pulmonary metastases located centrally as compared with peripheral lesions. METHODS:A retrospective review of patients 0 to 21 years old with a diagnosis of OS with pulmonary metastases on computed tomographic scan between 1985 and 2000 was completed. Demographics, metastasis location, survival, morbidity, and mortality were evaluated. RESULTS:Of 115 patients who had pulmonary metastasis secondary to OS, there were 96 wedge resections and 13 lobectomy/pneumonectomies in 84 patients. The morbidity of wedge resection was 9% and lobectomy/pneumonectomy was 8%. There were no deaths from surgery. The median survival for patients undergoing lobectomy compared with wedge resection was 0.61 and 1.14 years, respectively, but did not reach statistical significance. The median overall survival for the entire cohort was 0.75 years. The median overall survival after initial detection of metastatic disease was 1.06 years among the patients with peripheral disease, compared with 0.38 years in patients with central disease (P = .008). CONCLUSION:Patients with central pulmonary metastases in OS have a very poor prognosis, even after operative treatment, compared with those with peripheral disease. Patients with central lesions may benefit from other nonsurgical treatment options.

journal_name

J Pediatr Surg

authors

Letourneau PA,Xiao L,Harting MT,Lally KP,Cox CS Jr,Andrassy RJ,Hayes-Jordan AA

doi

10.1016/j.jpedsurg.2010.12.013

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

1333-7

issue

7

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(10)01114-0

journal_volume

46

pub_type

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