What is the role of surgery in the treatment of metastatic osteosarcoma?

Updated: Dec 04, 2018
  • Author: Charles T Mehlman, DO, MPH; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

Metastatic lung nodules can be cured by means of complete surgical resection (most often wedge resection). Lobar resection or pneumonectomy may occasionally be required for clear margins. This procedure should be performed at the time of the primary tumor resection. Although bilateral nodules can be resected via a median sternotomy, surgical exposure is superior with a lateral thoracotomy. Therefore, bilateral thoracotomies are recommended for bilateral disease (each side separated by a few weeks).

For an osteosarcoma that recurs as one or more lung lesions only more than 1 year after the patient is off therapy, surgical resection alone can be curative; the likelihood of metastases to other sites is low. Chemotherapy is warranted if recurrence occurs earlier; in such cases, the risk of other micrometastatic disease is high.


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