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Published on: May 8, 2018
Multimodal treatment of osteosarcoma lung metastases
D Divisi1, D Gizzonio, R Crisci
1Department of Thoracic Surgery, University of L'Aquila, G. Mazzini Hospital, Circonvallazione Ragusa 39, 64100 Teramo, Italy. duilio.divisi@virgilio.it
Objective:
The diagnostic procedures, role of surgery and multimodal treatment for osteosarcoma pulmonary metastases are examined.
Methods:
From January 2000 to June 2005, we observed 35 patients with osteogenic repetitions. Patients were studied by total-body computerised tomography (CT) and by thoracic single-photon emission computerised tomography (SPECT). Preoperative histological diagnosis was obtained by CT-guided transthoracic needle biopsy (23 cases) and fibre-optic bronchoscopy (12 cases).
Results:
Four lower, 6 upper and 2 middle lobectomies were carried out using a thoracotomy approach. Video-assisted thoracoscopy was used in the other 23 patients who underwent 36 wedge resections. CT showed a sensitivity of 86 % and a specificity of 66 %; SPECT had a sensitivity of 80 % and a specificity of 100 %. Twenty-five patients are still living 25 +/- 11 months after the intervention.
Conclusions:
SPECT was demonstrated to offer a better result in the individualisation of secondary pulmonary nodules after primary osteosarcoma. The excision of all resectable lung metastases, integrated in a multidisciplinary strategy, offers good results in terms of survival.
