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Effect of timing of pulmonary metastasis occurrence on the outcome of metastasectomy in osteosarcoma patients
Effect of timing of pulmonary metastasis occurrence on the outcome of metastasectomy in osteosarcoma patients
- Source :
- Journal of Pediatric Surgery. 54:775-779
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Complete metastasectomy is the best predictor of survival in patients with osteosarcoma pulmonary metastases. There has been some controversy in the literature regarding the prognostic significance of the timing of occurrence of lung metastasis.We reviewed the clinical course of all osteosarcoma patients with pulmonary metastases treated by metastasectomy in our hospital from January 2008 through December 2016. Each patient who underwent metastasectomy was placed into one of three groups based on whether lung metastases were present at initial presentation (Group 1), developed during chemotherapy (Group 2), or appeared after completion of chemotherapy (Group 3). Data were obtained retrospectively and follow-up was obtained until the end of June 2017.We identified 170 patients with pulmonary nodules of whom 99 (58.2%) underwent at least one metastasectomy (149 thoracotomies). Eleven patients had benign pulmonary nodules and were excluded. The other 88 patients were classified as Group 1 (37), Group 2 (18) or Group 3 (33). The median follow-up was 35 months (range 8 to 99). Postmetastasis 5-year overall survival (OS) was 38.1 ± 6.4%; event-free survival (EFS) was 25 ± 5.3%. By group, postmetastasis 5-year OS and EFS were 34.3 ± 13% and 18 ± 9.3% in Group 1, 8 ± 6.5% and 6.5 ± 5% in Group 2, and 52 ± 11.4% and 25 ± 9% in Group 3 (P 0.001). In univariate analysis, the only significant factors associated with survival were timing of occurrence of lung metastasis and the number of lung nodules found.The timing of occurrence of lung metastasis is an important prognostic factor among osteosarcoma patients eligible for metastasectomy. Patients whose metastases occurred during chemotherapy had the worst survival.Level II.
- Subjects :
- Male
medicine.medical_specialty
Lung Neoplasms
Time Factors
Adolescent
medicine.medical_treatment
Lung metastasis
Bone Neoplasms
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Pulmonary metastasis
In patient
Child
Neoplasm Staging
Retrospective Studies
Osteosarcoma
Chemotherapy
Lung
business.industry
Metastasectomy
General Medicine
Prognosis
medicine.disease
Survival Analysis
Neoadjuvant Therapy
Surgery
medicine.anatomical_structure
Thoracotomy
Child, Preschool
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Complete Metastasectomy
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....429f9350b3812d9c55283eb9967b8922
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2018.06.019