and surgery for pulmonary metastases

Twenty-three patients presented with isolated pulmonary metastases from osteogenic sarcoma following primary treatment by ampu- tation or limb salvage, combined with chemo- therapy. The metastases were treated by conserva- tive surgical excision combined with chemo- therapy; surgical excision was repeated for re- current pulmonary metastases, provided there were none elsewhere. Six patients are alive and disease-free following their initial surgery. Of the remaining 17, 10 had recurrence confined to the lungs, and 7 developed extra-pulmonary metas- tases. The 10 with isolated pulmonary metastases all had further thoracotomies but eventually 7 died, as did all those with extra-pulmonary metas- tases. There were in all 45 operations, with 1 hos- pital death and 1 serious complication. Actuarial survival at 1, 3, 5 and 7 years was 87%, 45%, 39% and 31%, respectively. In the 10 patients who had recurrence of isolated pulmonary metastases, sur- vival at 1 and 3 years was 70% and 34%. (Eur J Cardio-thorac Surg (1988) 2: 37-421