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Pulmonary Metastasis From Osteosarcoma

Pulmonary Metastasis From Osteosarcoma

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Pulmonary Metastasis From Osteosarcoma

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  1. 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

  2. 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.

  3. 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.

  4. RESULTS 247 Total 1988-2003 M0 at presentation 209 (84.6%) Synchronous Mets 38 (15.4%)

  5. 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

  6. 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%)

  7. Variables related to 1st lung involvement( only the operated cases, 47pts)..

  8. 85 patients: 3 year PLMS: 30%

  9. 3 year PLMS: Synchronous mets: 30 % Metachronous mets: 30 %

  10. 3 year PLMS: NO lung surgery: 16 % lung surgery: 38 %

  11. 3 year PLMS: 1-3 lesions: 69 %≥ 4 lesions: 18 %

  12. 3 year PLMS: Unilateral: 55 % Bilateral: 32 %

  13. 3 year PLMS: ≤ 1 cm: 67 % > 1 cm: 34 %

  14. 3 year PLMS: No chemo: 39 % Chemo: 33 %

  15. DISCUSSIONLATEST LARGE SERIES

  16. 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.

  17. ACKNOWLEDGMENT Anthony Griffin Melania Pintilie

  18. THANK YOU