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DOI: 10.1055/s-2006-923918
© Georg Thieme Verlag KG Stuttgart · New York
Multimodal Treatment of Osteosarcoma Lung Metastases
Publication History
Received December 28, 2005
Publication Date:
10 August 2006 (online)
![](https://www.thieme-connect.de/media/thoracic/200605/lookinside/thumbnails/10.1055-s-2006-923918-1.jpg)
Abstract
Objective: The diagnostic procedures, role of surgery and multimodal treatment for osteosarcoma pulmonary metastases are examined. Methods: From January 2000 to June 2005, we observed 35 patients with osteogenic repetitions. Patients were studied by total-body computerised tomography (CT) and by thoracic single-photon emission computerised tomography (SPECT). Preoperative histological diagnosis was obtained by CT-guided transthoracic needle biopsy (23 cases) and fibre-optic bronchoscopy (12 cases). Results: Four lower, 6 upper and 2 middle lobectomies were carried out using a thoracotomy approach. Video-assisted thoracoscopy was used in the other 23 patients who underwent 36 wedge resections. CT showed a sensitivity of 86 % and a specificity of 66 %; SPECT had a sensitivity of 80 % and a specificity of 100 %. Twenty-five patients are still living 25 ± 11 months after the intervention. Conclusions: SPECT was demonstrated to offer a better result in the individualisation of secondary pulmonary nodules after primary osteosarcoma. The excision of all resectable lung metastases, integrated in a multidisciplinary strategy, offers good results in terms of survival.
Key words
Osteosarcoma - SPECT - lung metastases - multimodal therapy
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Dr. Duilio Divisi
Department of Thoracic Surgery
University of L'Aquilla, “G. Mazzini” Hospital
Circonvallazione Ragusa 39
64100 Teramo
Italy
Phone: + 39861429482
Fax: + 39 8 61 42 94 78
Email: duilio.divisi@virgilio.it