Clinical Outcomes and Surgical Procedures for Patients With Osteosarcoma and Metachronous Lung Metastasis: A Chronological Analysis.

BACKGROUND AND

OBJECTIVES

Osteosarcoma (OS) survival rates have remained unchanged for decades, while video-assisted thoracic surgery (VATS) for lung metastasis (LM) became common. We aimed to clarify clinical outcomes of post-relapse survival (PRS) for patients with OS based on LM-free survival (LMFS) across different eras.

METHODS

This single-centre retrospective study included 168 patients with OS without LM at initial diagnosis. Patients were categorised into three groups: non-LM (n = 89), synchronous LM (sLM: less than 1-year LMFS) (n = 40), and mLM (at least 1-year LMFS) (n = 39). We compared PRS in patients with sLM and mLM across periods 1 (1990-2005) and 2 (2006-2022).

RESULTS

PRS for mLM was longer in period 2 than in period 1 (Hazard ratio: 0.37, 95% confidence interval: 0.12-0.97, p = 0.04), whereas no difference was observed for sLM. In mLM, ratios of surgery, radiotherapy, and chemotherapy were unchanged; the rate of VATS increased in period 2 (7/18 vs. 10/12, p = 0.01). The rate of reoperation remained unchanged (7/18 vs. 7/12, p = 0.39).

CONCLUSIONS

In period 2, mLM had a better prognosis than in period 1. There was an increased use of VATS, while the rates of reoperation for LM remained unchanged. Conversely, the prognosis for sLM was not altered.