Radiation therapy was used in both regimens pre and post operativly, chemotherapy was also used in 85% of the patients, and was not dependent of tumor histotype. 23 patients were submited to surgery of lung metastasis. Survival rates were determined and compared with stage (AJCC), tumor histotype and surgical margins.
In the last ten years, 172 bone sarcomas and 126 soft tissue sarcomas, were treated by our Orthopaedic Oncology Unit. From those patients 49 (16.5%) meet criteria for pulmonary metastasis resection. Patient group were 27 males (55%) and 22 females (45%); median age 28.8 years (range 12–71); histology of the primary tumours were in 33 cases bone lesions (67%): 17 osteosarcomas, 8 Ewing sarcomas, 3 Malignant Fibrous Histiocytoma (MFH) and 1 Giant Cell Tumor and 16 cases (23%) for soft tissue tumours: 5 synovial sarcoma, 3 schwannoma and MFH, 2 leiomiosarcoma and liposarcoma and 1 rhabdomyosarcoma. From those sarcomas 8 (17.8%) were metastatic at presentation. Treatment included surgical resections of the secondary lesions and chemotherapy. The lung metastasis were bilateral in 20 cases (41%) and unilateral in 29 cases (59%). The number of metastasis range from one to 24 and the surgical sessions for each patient were from one to eight. The median disease free survival in the patients with no metastatic lesions at presentation was 17.8m (range 2–88). From this group of patients 25 (51%) were dead of disease (DOD), and 24 (49%) were survivors (median follow-up 42 month: range 12–120 month), being 14 with no evidence of disease (NED) and 10 alive with disease (AWD). The authors perform a statistical analysis relating survival with local recurrence and the amount of necrosis in the surgical specimen.
