Recurrent osteosarcoma with a single pulmonary metastasis: a multi-institutional review

Area of Science:

• Oncology
• Surgical Oncology
• Pediatric Oncology

Background:

• Recurrent osteosarcoma with late relapse and solitary lesions indicates a better prognosis.
• Pulmonary metastases are a common site of recurrence in osteosarcoma.

Purpose of the Study:

• To evaluate the outcomes of patients with recurrent osteosarcoma presenting as a single pulmonary metastasis.
• To assess the impact of chemotherapy on survival in this patient group.

Main Methods:

• Retrospective review of 39 patients with recurrent osteosarcoma and a single pulmonary metastasis diagnosed >1 year after initial diagnosis.
• Analysis of clinical factors and treatment, including metastasectomy and chemotherapy, on post-relapse survival.

Main Results:

• Metastasectomy was the primary treatment for all patients; 31% received additional chemotherapy.
• No significant difference in recurrence time or nodule size was observed between chemotherapy and non-chemotherapy groups.
• 5-year and 10-year post-relapse event-free survival rates were approximately 33%; post-relapse survival rates were around 53-57%.

Conclusions:

• Approximately half of patients with recurrent osteosarcoma (single pulmonary metastasis >1 year post-diagnosis) achieved long-term survival.
• Metastasectomy is the crucial treatment, with chemotherapy showing no additional benefit.
• Late relapse and solitary lesions remain positive prognostic indicators.