Thorac Cardiovasc Surg 2006; 54(5): 328-331
DOI: 10.1055/s-2006-923918
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Multimodal Treatment of Osteosarcoma Lung Metastases

D. Divisi1 , D. Gizzonio2 , R. Crisci1
  • 1Department of Thoracic Surgery, University of L'Aquila, “G. Mazzini” Hospital, Teramo, Italy
  • 2Department of General Surgery, “Val Vibrata” Hospital, Sant'Omero, Italy
Further Information

Publication History

Received December 28, 2005

Publication Date:
10 August 2006 (online)

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.

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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