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Pulmonary Metastasis From Osteosarcoma. Multi-factorial analysis of survival at first lung involvement Ali Aljubran, Martin Blackstein for the University of Toronto Musculoskeletal Oncology Group. INTRODUCTION.

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pulmonary metastasis from osteosarcoma

Pulmonary Metastasis From Osteosarcoma

Multi-factorial analysis of survival

at first lung involvement

Ali Aljubran, Martin Blackstein

for the University of Toronto Musculoskeletal Oncology Group

introduction
INTRODUCTION
  • The cure rate of non-metastatic cases has improved from 20% (Pre chemotherapy era) to 65%.
  • Recurrence still occurs in approximately 30%.
  • More than 80% of all relapses involve the lungs.
  • Complete surgical resection is the only potential curative treatment.
  • Single institute review.
patients and methods
PATIENTS AND METHODS
  • Osteosarcoma patients (1988-2003).
  • Variables at the first lung involvement , e.g. RFI, multiplicity and laterality of lesions and size of the largest nodule are all analyzed. Peri operative chemotherapy was also analyzed.
  • Statistical methods: Post lung metastasis survival PLMS was calculated from the date of the first lung metastasis to the date of death or last follow-up.
results
RESULTS

247

Total

1988-2003

M0 at

presentation

209

(84.6%)

Synchronous

Mets

38 (15.4%)

results5
RESULTS

247

Total

1988-2003

No relapse

145

(69.4%)

M0 at

presentation

209

(84.6%)

Isolated LR

8 (3.8%)

Synchronous

Mets

38 (15.4%)

Metachronous

Mets

56(26.8%)

Total 94

results6
RESULTS

247

Total

1988-2003

No relapse

145

(69.4%)

Med. FU

2.7y

M0 at

presentation

209

(84.6%)

Isolated LR

8 (3.8%)

Synchronous

Mets

38 (15.4%)

Metachronous

Mets

56(26.8%)

Total 94

DOD

58

(68.2%)

AWED

12

(14.1%)

Lung+/-others

85

Isolated Bone

9

ANED

15

(17.6%)

3 year plms synchronous mets 30 metachronous mets 30
3 year PLMS: Synchronous mets: 30 % Metachronous mets: 30 %
conclusion
CONCLUSION
  • This is a large series from single center that primarily includes adult patients with median follow up of 2.7 years.
  • The 3 year PLMS is 30% which is comparable to previous large studies.
  • Surgical resection doubled the survival at 3 years.
  • Both Synchronous and Metachronous lung metastasis have similar survival.
  • Lung nodules of <4, size ≤ 1cm and unilaterality are favorable prognostic factors.
  • The use of chemotherapy with the resection did not appear to affect the survival.
acknowledgment
ACKNOWLEDGMENT

Anthony Griffin

Melania Pintilie