The Thoracic and cardiovascular surgeon · 2006
Multimodal treatment of osteosarcoma lung metastases.
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Divisi D, Gizzonio D, Crisci R
Аннотация
OBJECTIVE: The diagnostic procedures, role of surgery and multimodal treatment for osteosarcoma pulmonary metastases are examined.
METHODS: From January 2000 to June 2005, we observed 35 patients with osteogenic repetitions. Patients were studied by total-body computerised tomography (CT) and by thoracic single-photon emission computerised tomography (SPECT). Preoperative histological diagnosis was obtained by CT-guided transthoracic needle biopsy (23 cases) and fibre-optic bronchoscopy (12 cases).
RESULTS: Four lower, 6 upper and 2 middle lobectomies were carried out using a thoracotomy approach. Video-assisted thoracoscopy was used in the other 23 patients who underwent 36 wedge resections. CT showed a sensitivity of 86 % and a specificity of 66 %; SPECT had a sensitivity of 80 % and a specificity of 100 %. Twenty-five patients are still living 25 +/- 11 months after the intervention.
CONCLUSIONS: SPECT was demonstrated to offer a better result in the individualisation of secondary pulmonary nodules after primary osteosarcoma. The excision of all resectable lung metastases, integrated in a multidisciplinary strategy, offers good results in terms of survival.
METHODS: From January 2000 to June 2005, we observed 35 patients with osteogenic repetitions. Patients were studied by total-body computerised tomography (CT) and by thoracic single-photon emission computerised tomography (SPECT). Preoperative histological diagnosis was obtained by CT-guided transthoracic needle biopsy (23 cases) and fibre-optic bronchoscopy (12 cases).
RESULTS: Four lower, 6 upper and 2 middle lobectomies were carried out using a thoracotomy approach. Video-assisted thoracoscopy was used in the other 23 patients who underwent 36 wedge resections. CT showed a sensitivity of 86 % and a specificity of 66 %; SPECT had a sensitivity of 80 % and a specificity of 100 %. Twenty-five patients are still living 25 +/- 11 months after the intervention.
CONCLUSIONS: SPECT was demonstrated to offer a better result in the individualisation of secondary pulmonary nodules after primary osteosarcoma. The excision of all resectable lung metastases, integrated in a multidisciplinary strategy, offers good results in terms of survival.
Предметные рубрики MeSH
AdultAgedAntineoplastic AgentsBiopsy, NeedleBone NeoplasmsBrain NeoplasmsBronchoscopyCombined Modality TherapyFemaleFollow-Up StudiesHumansLiver NeoplasmsLung NeoplasmsMaleMiddle AgedNeoplasm Recurrence, LocalOsteosarcomaSensitivity and SpecificityThoracoscopyThoracostomyTomography, Emission-Computed, Single-PhotonTomography, X-Ray ComputedTreatment Outcome