Pulmonary metastases in children with osteosarcoma: characteristics and impact on patient survival
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Darshana D. Rasalkar & Winnie C. W. Chu & Vincent Lee & Bhawan K. Paunipagar & Frankie W. T. Cheng & Chi Kong Li
- چاپ و سال / کشور: 2010
Description
Background Approximately 15–20% of patients with osteosarcoma present with detectable metastatic disease and the majority of whom (85%) have pulmonary lesions as the sole site of metastasis. Previous studies have shown that the overall survival rate among patients with localized osteosarcoma without metastatic disease is approximately 60–70% whereas survival rate reduces to 10–30% in patients with metastatic disease. Objective To determine the incidence and characteristic features of pulmonary metastases in a group of osteosarcoma patients and correlate the findings with the prognostic outcome/survival. Materials and methods Seventy-seven cases of histologically confirmed osteosarcoma were reviewed (47 male, 30 female, mean age 10.9). The site and size of the primary tumour and degrees of chemonecrosis were recorded. Lung metastases were analyzed according to their size, number, distribution and interval from diagnosis. The Kaplan-Meier method was used to analyze the survival probability curve. Significant differences (P<0.05) were evaluated with the log-rank test for univariate analyses. Results Seventeen patients had synchronous and 11 had metachronous lung metastases. Sixteen (57%) underwent pulmonary metastasectomy. Nine of sixteen (56%) patients with metastasectomy and 10/12 (83%) patients without metastasectomy died. Poor chemonecrosis was associated with a worse outcome. Number, distribution and timing of lung metastases, but not the size of lung metastases, were of prognostic value for survival. Conclusion Radiological detection of lung metastases is clinically important as it indicates a worse prognosis.
Pediatr Radiol (2011) 41:227–236 DOI 10.1007/s00247-010-1809-1 Received: 17 February 2010 / Revised: 19 July 2010 / Accepted: 19 July 2010 / Published online: 3 September 2010
