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September 1992

Surgical Treatment and Chemotherapy for Pulmonary Metastases From Osteosarcoma

Author Affiliations

From the Divisions of Surgical Oncology (Drs Skinner, Eilber, and Holmes) and Orthopedic Surgery (Dr Eckardt), UCLA School of Medicine; and Comprehensive Cancer Center, Cedars-Sinai Medical Center (Dr Rosen), Los Angeles. Dr Skinner is a recipient of a clinical oncology fellowship from the American Cancer Society.

Arch Surg. 1992;127(9):1065-1071. doi:10.1001/archsurg.1992.01420090073010

• 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.

(Arch Surg. 1992;127:1065-1071)