Management of osteogenic sarcoma at the Mayo Clinic

In a Mayo Clinic prospective study of metastasis from osteogenic sarcoma, so-called prophylactic whole-lung irradiation (a 1,500-rad tumor dose to the whole of both lungs, in divided doses, with oxygen and actinomycin) proved ineffective. 14 patients underwnet an operation for metastatic pulmonary disease. The earlier the excision of a metastatic lesion, the greater the chance of an effective cure. Preoperative irradiation of the bone tumor had no positive effect. The primary lesion should also be excised as soon as possible. Surgical removal of a tumor should be followed by immunotherapy or chemotherapy or both. The rate of reliably "cured" cases could be improved by extensive studies of immunologic reaction before and after surgical intervention.