Prolonged Survival in Osteogenic Sarcoma with Multiple Pulmonary Metastases A CASE REPORT AND REVIEW OF THE LITERATURE

In recent years. numerous authors have reviewed the experience of pulmonary surgery for metastatic disease 10. 12. 13#{149}The consensus seems to be that resection should be considered only if the primary site has been completely treated, if the lesion is resectable, if there is no other extrapulmonary involvement, and if the pa-tient can tolerate the procedure. Some authors advocate excisions of multiple nodules, while others believe that only a solitary lesion should be removed, although it is often difficult to ascertain preoperatively that a metastasis is indeed solitary. With respect to survival, sonic authors maintain that there is no correlation be-tween cell type, size of metastasis, type of pulmonary surgery (as long as the entire lesion is removed), and presence or lack of symptoms a I0 In fact, Martini and asso-ciates and Thomford and associates 13 found no difference in five-year survival rates with solitary or multicentric unilateral nodules. Thomford, Woolner, and Clagett reported an over-all five-year survival rate of 30 per cent. The survival in metastatic carcinoma (32.5 per cent) was somewhat better than in metastatic sarcoma (23. 1 per cent). In Gleidman, Horowitz, and Lewis’s series, the five-year surviva