Osteosarcoma Patients with Recurrent Lung Metastases May Benefit from Additional SurgeryOsteosarcoma frequently spreads to the lungs, and in some cases these lung metastases can be surgically removed. When the lung metastases recur after surgery, additional lung surgery may be warranted, according to a study published in the journal Cancer .
Osteosarcoma is a type of cancer that originates in the bone. Patients with osteosarcoma are often young; the disease most commonly affects individuals between 10 and 25 years of age. Standard treatment for osteosarcoma depends largely on the stage, or extent of spread. If the cancer is confined to an extremity, standard treatment typically consists of chemotherapy, surgery to remove the cancer, and possibly radiation therapy.
When osteosarcoma metastasizes, it frequently spreads to the lungs. Surgical removal of the lung metastases is a common treatment approach, but the lung metastases sometime recur following surgery. Among osteosarcoma patients with recurrent lung metastases, there is little information about how repeated lung surgeries effect survival.
To evaluate patient outcomes after repeated lung surgeries for recurrent lung metastases, researchers in Italy evaluated 94 osteosarcoma patients who had at least two lung surgeries. The study was restricted to patients who had no metastases beyond the lung, were free of primary osteosarcoma, and had the possibility of complete removal of the metastases without causing serious breathing problems. The median age of study subjects was 17 years, with a range of 3–46 years. After the first lung surgery, 51% of patients received chemotherapy.
* There were no surgery-related deaths.
* Three- and five-year survival rates after the first lung surgery were 45% and 38%.
* Three- and five-year survival rates after the second lung surgery were 33% and 32%.
* Patients who had a local recurrence or a greater number of metastases had a worse prognosis.
* Patients who had a longer interval between initial osteosarcoma surgery and first lung surgery or between the first and second lung surgeries had better survival.
Patients who continued to develop lung recurrences and who remained candidates for surgery had up to five lung surgeries. The researchers note, “Results after second or further [lung surgeries] were good because at least 30% of patients were freed of disease.”
The researchers conclude, “Surgery, combined with chemotherapy, can favorably influence prognosis of carefully selected osteosarcoma patients who have repeated lung recurrences.”
Reference: Briccoli A, Rocca M, Salone M et al. Resection of Recurrent Pulmonary Metastases in Patients with Osteosarcoma. Cancer. 2005;104:1721-5.
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