Pulmonary metastases from osteosarcoma

Between January 1979, and December 1990, 16 young patients (9 males and 7 females, at an average age of 19 ys., range, 10-25) were observed for the detection of pulmonary metastases from osteosarcoma. The average disease-free interval from the treatment of the primary bone tumor was 14 months (range, 1-36). In all otherwise asymptomatic patients the pulmonary metastases (one metastasis in 9 patients, and more than one in 7) were detected during routine radiological follow-up (nine in the left lung and seven in the right lung). Six patients presenting with local relapses of primary tumor (4), disseminated metastatic disease (1), and poor functional reserve (1), were excluded from surgery. Ten patients (62.5%) underwent 12 operations. The type of surgery was pneumonectomy in 2 patients (in 1 of them for recurrent disease, i.e., completion pneumonectomy), lobectomy in 6 (in 1 one of them for recurrent disease following a wedge resection), and, wedge resection in 4 patients. Perioperative mortality was 0%. The observed five-year survival in the operated and in the non-operated patients was 35% and 0%, respectively.