A retrospective analysis of thirty patients who underwent pulmonary
resection for metastatic osteosarcoma over a twenty-eight-year period
revealed that most were young males with previous amputations for primary
lesions of the lower extremity. In each, one to four thoracotomies had been
performed, for a total of fifty-two chest operations with resection of 124
pulmonary metastatic lesions. At last follow-up, eleven of the thirty
patients were alive and free of disease. At five years 28 per cent had
survived: three of them were alive at more than nine years, and one was
alive at nearly twenty years. Adverse survival factors identified were
short tumor-free interval and multicentricity of pulmonary metastases.
Long-term survival was associated with a tumor-free interval of more than
two years and one to four thoracotomies at which few foci were present. As
a group, patients selected for lung resection had significantly longer
suvival than did patients whose pulmonary metastasis was untreated.