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Surgical Treatment and Chemotherapy for Pulmonary Metastases From Osteosarcoma

Kristin A. Skinner, MD; Frederick R. Eilber, MD; E. Carmack Holmes, MD; Jeffrey Eckardt, MD; Gerald Rosen, MD
Arch Surg. 1992;127(9):1065-1071. doi:10.1001/archsurg.1992.01420090073010.
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• Between 1971 and 1991, 247 patients with stage I osteosarcoma were treated at UCLA. Patients were treated in four sequential groups, with group 1 receiving surgery alone, and groups 2 through 4 receiving various adjuvant chemotherapeutic regimens. The incidence of lung metastases in these patients decreased from 92% (group 1) to 31% (group 4), while the proportion of patients undergoing pulmonary resection increased (17% vs 82%). Overall 5-year survival rate among patients with pulmonary metastases increased from 0 in group 1 to 41 % (actuarial) in group 4. No clinical factor correlated significantly with outcome using univariate analysis, although there was a trend toward prolonged survival in those with longer disease-free intervals. Adjuvant chemotherapy and resection of pulmonary metastases have transformed a uniformly fatal condition into one with a reasonable expectation of long-term survival.

(Arch Surg. 1992;127:1065-1071)

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