Resection of pulmonary metastases of osteogenic sarcomas / 中华骨科杂志

ABSTRACT

Objective Through retrospective analysis of the thoracotomy of pulmonary metastases form osteogenic sarcomas in order to explore the related factors of prognosis and to improve the outcome of treatment.Methods From October1980to March2003,32cases with pulmonary metastases from sarcoma of bone were reviewed.62of thoractomy were performed for the patients,61of which were accomplished in the department of orthopaedics,and58operations were performed by the authors.There were32males and10females aging from11to61years with an average of 22.1years.The primary tumors of the patients were25oateosarcomas,3chondrosarcomas,2juxtacortical osteogenic sarcomas,and1each of fibrosarcoma and Ewings sarcoma.Of 32cases,21(65.6%)were treated with limb salvage,and11(34.4%)by am puta-tion.According to Enneking system,there wereⅡB in26andⅢB in5.25(78.1%)cases were bi lateral multiple metastases,6(18.8%)cases were unilateral solitary metastasis,and1(3.1%)case was unilateral mul tiple metastases.Most of the procedures of operation were local resection of the tumor ;however,only5cases underwent lobectomy.Results The postoperative complications included1case of severe bleeding cured by exploratory thoracotomy,2cases of lethal infections,and1case of atelectasis.Of 32cases,11sur -vived with out tumor at final follow-up.In25osteosarcoms,16were dead,2were lost from the follow-up;7cases of the other18cases that bilateral resections performed,were alive without tumor (38.9%)with a me di an survival time of 7years and3months.1each of Ewings sarcoma,paraosteal osteosarcoma and,chon-drosarco ma survived without tumor for 22years and5months,19years and3months,and13years and3months respectively.Conclusion Thoracotomy of pulmonary metastases of osteogenic sarcomas is an ef-fective method to salvage the patients life.The procedure of metastasectomy is local resection.The results al-so suggest that newadjurant chemotherapy is a important way to effect the condition of pulmonary metastases of osteogenic sarcomas.