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Oligo-Recurrence of Osteosarcoma Patients: Treatment Strategies for Pulmonary Metastases

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Distant metastases from osteosarcoma most commonly occur in the lungs. Osteosarcoma can be cured by complete surgical resection of all metastatic lesions if the number is limited (oligo-recurrence: ≤5 metastatic or recurrent lesions with controlled primary lesions). This study aimed to clarify the prognostic factors for osteosarcoma patients with pulmonary metastasis and determine their oligo-recurrence status.

Methods

Patients with conventional osteosarcoma who underwent definitive surgery for the primary lesion and at least one thoracotomy for pulmonary metastases were recruited to this retrospective study. Clinicopathological information was collected on each thoracotomy from 1976 to 2011, and was then analyzed statistically. We counted the number of resected nodules that were pathologically confirmed as metastatic lesions from osteosarcoma.

Results

In total, 151 thoracotomies in 71 patients were analyzed. Forty-seven patients (66 %) underwent up to two thoracotomies, and the maximum number of thoracotomies was six. The median number of resected nodules on each thoracotomy was two, and the median total size of metastatic lesions was 20 mm. Incomplete surgical remission [relative risk (RR) 3.42], a less than 1-year interval from a previous thoracotomy (RR 1.97), more than three resected nodules (RR 2.42); and total size of more than 30 mm for pulmonary metastases (RR 2.19) were independent predictors of increased risk of tumor death by multivariate analysis.

Conclusions

We propose that factors contributing to oligo-recurrence of patients with pulmonary metastatic osteosarcoma include complete surgical remission, an interval from a previous thoracotomy, number of resected nodules, and total size of pulmonary metastases.

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Acknowledgment

The authors would like to thank Enago (www.enago.jp) for reviewing the English language in this article.

Conflict of interest

Shintaro Iwata, Tsukasa Yonemoto, Toshihiko Iizasa, Yuzuru Niibe, Hiroto Kamoda, and Takeshi Ishii declare that they have no conflict of interest.

Funding

This work was supported in part by a National Cancer Center Research and Development Fund (26-A-4) and Cancer Research Funds for Patients and Family.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Chiba Cancer Center, Chiba, Japan

    Shintaro Iwata MD, Tsukasa Yonemoto MD, Hiroto Kamoda MD & Takeshi Ishii MD

  2. Division of Thoracic Disease, Chiba Cancer Center, Chiba, Japan

    Toshihiko Iizasa MD

  3. Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan

    Yuzuru Niibe MD

Authors
  1. Shintaro Iwata MD
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  2. Tsukasa Yonemoto MD
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  3. Toshihiko Iizasa MD
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Correspondence to Shintaro Iwata MD.

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Iwata, S., Yonemoto, T., Iizasa, T. et al. Oligo-Recurrence of Osteosarcoma Patients: Treatment Strategies for Pulmonary Metastases. Ann Surg Oncol 22 (Suppl 3), 1332–1338 (2015). https://doi.org/10.1245/s10434-015-4682-1

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  • DOI: https://doi.org/10.1245/s10434-015-4682-1

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