High Grade Osteosarcoma of the Extremities With Lung Metastases at Presentation: Treatment With Neoadjuvant Chemotherapy and Simultaneous Resection of Primary and Metastatic Lesions
High Grade Osteosarcoma of the Extremities With Lung Metastases at Presentation: Treatment With Neoadjuvant Chemotherapy and Simultaneous Resection of Primary and Metastatic Lesions
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DOI：
10.1002/jso.21140
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发表时间：
2008-11-01
影响因子：
2.5
通讯作者：
Briccoli, Antonio
中科院分区：
文献类型：
--
作者：
Bacci, Gaetano;Rocca, Michele;Briccoli, Antonio
背景和方法：1986年至2001年间，162例四肢骨肉瘤合并肺转移患者接受了新辅助化疗，同时切除原发灶和可行的继发灶，然后进行化疗。结果：新辅助化疗后，14例患者转移灶消失，其中16例被我们的胸外科医生判断为不可切除， 132 例同时切除了原发肿瘤和肺转移瘤。 123 名患者的肺转移瘤被完全切除，9 名患者的肺转移瘤切除不完全。32 名患者的组织学病变为良性。对于100名同时接受组织学证实肺转移的患者，5年无事件生存率（EFS）为18.91%； 91 名完全切除肺部病灶并进入缓解期的患者中有 27.4% 进入缓解期，而 9 名未完全切除肺结节的患者则没有进入缓解期。在这 91 名患者中，单侧病变患者的 5 年 EFS 显着高于双侧病变患者（27.1% vs. 7.9%。P < 0.02），当仅存在一到三个转移结节时（40.0% vs. 13.3%，P < 0.0001）。结论：这些不同的结果表明，我们的治疗具有合理的生存结果，而其他组的预后仍然较差。应做出更多努力，通过识别新的活性药物或具有细胞分子靶标的新方法来提高生存率。 J.外科医生。安科尔。 2008:98:415-420 (c) Wiley-Liss, Inc.
Background and Methods: Between 1986 and 2001.162 patients with extremity osteosarcoma and lung metastases at presentation, were treated by neoadjuvant chemotherapy, simultaneous resection of primary and, when feasible, secondary lesions followed by chemotherapy.Results: After neoadjuvant chemotherapy, metastases disappeared in 14 patients, 16 were judged unresectable by both our thoracic surgeons, 132 had primary tumors and lung metastases removed simultaneously. Removal of lung metastases was complete in 123 and incomplete in 9. Histologically lesions were benign in 32 patients. For the 100 patients simultaneously operated with histologically proven lung metastases, 5-year event-free survival (EFS) was 18.91%; 27.4% for the 91 who had a complete resection of pulmonary lesions and entered remission as opposed to none for 9 patients who had incomplete removal of lung nodules. Among these 91, 5-year EFS was significantly higher for patients with monolateral compared to bilateral lesions(27.1% vs. 7.9%. P < 0.02) and when only one to three metastatic nodules were present (40.0% vs. 13.3%, P < 0.0001).Conlcusions: These different results, demonstrate that our treatment had a reasonable survival outcome whereas other groups continue to have dismal prognosis. More efforts should be made to improve survival by identifying new active agents or novel approaches with cellular molecular targets. J. Surg. Oncol. 2008:98:415-420 (c) Wiley-Liss, Inc.