Abstract
14 video-assisted thoracoscopical surgeries (VATS) for pulmonary metastasis in cases of bone and soft tissue sarcomas were performed between March 1990 to July 2002, and were followed for 2 to 50 months (mean, 22.1 months). The mean age at diagnosis was 31.6 years (14-73 years). The histologic diagnosis of the primary tumor was osteosarcoma in 8 patients, chondrosarcoma in 2, malignant peripheral nerve sheath tumor in 2, and others in 2. Surgical treatments for primary lesions were 9 wide resections, and 5 amputations. Bilateral pulmonary metastases were in 6 cases and unilateral one were in 8 cases. Four patients had more than 5 pulmonary metastastic lesions each, and 10 patients had less than 5 lesions.
This study was performed to compare two groups for factors of prognosis including the type of surgical procedure, bilateral or unilateral location, the number of metastases, and the period between surgical treatment for the primary lesion and appearance of metastases. The 3-year survival rate after surgical treatment of primary lesion was 44.9%. The current study showed no significant difference between the groups, but a tendency of better prognosis was seen in the unilateral cases, in cases with fewer than 5 lesions of pulmonary metastasis, and in cases in which metastasis was detected after 1 year or more after surgical treatment of the primary tumor.
In order to improve clinical results for pulmonary metastasis, it is important to resect pulmonary metastases when positive indication has been fully discerned.
