Prognostic factors of pulmonary metastasectomy for osteosarcomas of the extremities

Background: Factors affecting recurrence and survival after pulmonary resection for metastatic osteosarcomas are controversial. To confirm a role for resection of pulmonary metastases for such tumors, we herein reviewed our institutional experience. Methods: Between 1989 and 2007, 23 patients with pulmonary metastases from osteosarcomas of the extremities underwent pulmonary resection. Various perioperative variables were investigated retrospectively to confirm a role for metastasectomy and to analyze prognostic factors for overall survival and disease-free survival after metastasectomy. Results: Overall survival rate after metastasectomy was 31% at 5 years. Disease-free survival rate was 19% at 5 years after pulmonary resection. On multivariate analysis, patients with less than five pulmonary metastases and patients without pulmonary metastases identified during pre- and postoperative chemotherapy presented significantly favorable overall survival (p = 0.015 and 0.0082, respectively). Furthermore, the number of pulmonary metastases less than five was the only significantly favorable prognostic factor for disease-free survival on univariate analysis (p = 0.0055). Conclusions: Current practice of pulmonary metastasectomy for osteosarcomas in our institution was welt justified. The number of pulmonary metastases more than five and the advent of pulmonary metastases during pre- and postoperative chemotherapy seemed relevant to a worse prognosis. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All, rights reserved.