Abstract
The concept of salvage surgery in osteosarcoma is based on solid knowledge of the natural history of this disease. Unlike many other solid tumors, sarcomas manifest the peculiar characteristic of organ-restricted spread [1,2]. In most cases, lung metastases are the only site of distant relapse, occurring in 50–80% of osteosarcomas [1,3]. Although, if the cure rates for childhood osteosarcoma have dramatically improved over the last 20 years, lung metastases still remain a major cause of failure, occurring in 40–50% of patients [4] and being refractory to salvage chemotherapy [5–7]. A summary of the reported results of salvage surgery in osteosarcoma is given in Table 30-1 [8–15].
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References
Friedman MA, Carter SK. The therapy of osteogenic sarcoma: current status and thoughts for the future. J Surg Oncol 4:482–510, 1972.
Weiss L, Gilbert HA (Eds.) Pulmonary Metastasis. GK Hall & Co, Boston, 1987, p 100.
Marcove R, Mike V, Hajek JV, et al. Osteogenic sarcoma under the age of 21: a review of 145 operative cases. J Bone Joint Surg 52A:411–418, 1970.
Link MP. Adjuvant therapy in the treatment of osteosarcoma. In: Important Advances in Oncology 1986, J.B. Lippincott, Philadelphia, 1986, pp 193–206.
Jaffe N, Smith E, Abelson HT, Frei E: Osteogenic sarcoma: alteration in the pattern of pulmonary metastases with adjuvant chemotherapy. J Clin Oncol 1:251–254, 1983.
Eilber F, Giuliano A, Eckardt J, et al. Adjuvant chemotherapy for osteosarcoma: a randomized prospective trial. J Clin Oncol 5:21–26, 1987.
Gasparini M, Tondini C, Azzarelli A, Fossati-Bellani F. Long-term evaluation of surgery followed by adjuvant adriamycin in osteogenic sarcoma. Eur J Cancer Clin Oncol 23:433–436, 1987.
Martini N, Huvos AG, Mike V, et al. Multiple pulmonary resections in the treatment of osteogenic sarcoma. Ann Thorac Surg 12:271–280, 1971.
Rosen G, Huvos AG, Mosende C, et al. Chemotherapy and thoracotomy for metastatic osteogenic sarcoma: a model for adjuvant chemotherapy and the rationale for the timing of thoracic surgery. Cancer 41:841–849, 1978.
Telander RL, Pairolero PC, Pritchard DJ, et al. Resection of pulmonary metastatic osteogenic sarcoma in children. Surgery 84:335–341, 1978.
Waine Fly M, Woltering G, Rosemberg SA. Aggressive pulmonary resection for metastatic osteogenic and soft tissue sarcomas. Ann Thorac Surg 37:123–127, 1984.
Goorin AM, Delorey MJ, Lack EE, et al. Prognostic significance of complete surgical resection of pulmonary metastases in patients with osteogenic sarcoma: analysis of 32 patients. J Clin Oncol 2:425–431, 1984.
Gundry SR, Coran AG, Lemmer J, et al. The influence of tumor microfoci on recurrence and survival following pulmonary resection of metastatic osteogenic sarcoma. Ann Thorac Surg 38:473–478, 1984.
Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg 38:323–330, 1984.
Pastorino U, Valente M, Gasparini M, et al. Lung resection as salvage treatment for metastatic osteosarcoma. Tumori, 1987.
Winkler K, Garbe G, Bieling P, Bielack S. COSS experience in treatment results of synchronous and metachronous metastases in osteosarcoma. In: Proceedings of the International Meeting: Osteosarcoma and Adult Soft Tissue Sarcoma: Present Trends. Aviano, Italy, March 21–22, 1991, p 32.
Pastorino U, Valente M, Gasparini M, et al. Resection of lung metastases as salvage treatment for sarcoma. J Surg Oncol 40:275–280, 1989.
Pastorino U, Gasparini M, Tavecchio L, et al. The contribution of salvage surgery to the management of childhood osteosarcoma. J Clin Oncol, 1991, in press.
Takita H, Edgerton F, Karakousis C, et al. Surgical management of metastases to the lung. Surg Gynec Obstet 152:191–194, 1981.
Regal AM, Reese P, Antkowiak J, et al. Median sternotomy for metastatic lung lesions in 131 patients. Cancer 55:1334–1339, 1985.
Roth JA, Pass HI, Wesley MN, et al. Comparison of median sternotomy and toracotomy for resection of pulmonary metastases in patients with adult soft-tissue sarcomas. Ann Thorac Surg 42:134–138, 1986.
Pastorino U, Valente M, Gasparini M, et al. Median sternotomy and multiple lung resections for metastatic sarcomas. Eur J Cardiothorac Surg 4:477–481, 1990.
Pastorino U, Valente M, Santoro A, et al. Results of salvage surgery for metastatic sarcomas. Ann Oncol 1:269–273, 1990.
Roth JA, Putnam JB, Wesley MN, Rosemberg SA. Differing determinants of prognosis following resection of pulmonary metastases from osteogenic and soft-tissue sarcoma patients. Cancer 1985, 55:1361-1366.
Jablons D, Steinberg SM, Roth J, et al. Metastasectomy for soft tissue sarcoma. Further evidence for efficacy and prognostic indicators. J Thorac Cardiovasc Surg 97:695–705, 1989.
Bacci G, Briccoli A, Picci P, et al. Osteosarcoma of the extremities metastatic at presentation: results obtained with primary chemotherapy followed by simultaneous resection of the primary and metastatic lesions. Cancer J 3:213–218, 1990.
Beattie EJ: Surgical treatment of pulmonary metastases. Cancer 54:2729–2731, 1984.
Beattie EJ, Harvey JC, Marcove R, Martini N. Results of multiple pulmonary resections for metastatic osteogenic sarcoma after two decades. J Surg Oncol 46:154–155, 1991.
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Pastorino, U., Gasparini, M., Azzarelli, A., Tavecchio, L., Ravasi, G. (1993). Salvage surgery for childhood osteosarcoma. In: Humphrey, G.B., Koops, H.S., Molenaar, W.M., Postma, A. (eds) Osteosarcoma in Adolescents and Young Adults: New Developments and Controversies. Cancer Treatment and Research, vol 62. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3518-8_30
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DOI: https://doi.org/10.1007/978-1-4615-3518-8_30
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