title: Long-term results after resection for bone sarcoma pulmonary metastases.
abstract: BACKGROUND
  Pulmonary metastases from bone sarcomas occur in approximately 40% of the cases. The combination of both chemotherapy and surgical resection is currently the standard treatment options for these patients. We aim to study the influence of different prognostic factors on long-term survival.
  
  
  METHODS
  We reviewed the prognostic factors and survival rate in 52 consecutive patients with pulmonary metastases from bone sarcomas. All of them were previously treated with chemotherapy and submitted to metastasectomy at our institution from 1996 to 2006. Clinical and demographic variables, related to the primary tumour as well as to the pulmonary metastases, and treatment procedures were registered. Univariate (log-rank) and multivariate (Cox regression) analysis were carried out to identify significant prognostic factors related to overall survival. Five-year survival rates were estimated using Kaplan-Meier methods.
  
  
  RESULTS
  Median follow-up was 28 months. Follow-up duration ranged 7-148 months; the median survival was 27 months. As many as 31% of the patients were alive without disease, 3% were alive with disease, 64% died of disease while 2% died from other causes. Complete resection was achieved in 49 cases (94%). The overall 3- and 5-year survival rates were 43% and 31%, respectively. Univariate analysis showed (1) disease-free interval between treatment of the primary bone tumour and first lung metastasectomy (DFI) and (2) disease-free interval between first and second lung surgery (DFI2) as prognostic factors. Gender, primary site, histology of primary tumour, surgical approach, number of lung nodules, type of lung resection and re-do lung surgery did not have a significant impact on survival.
  
  
  CONCLUSIONS
  The long-term survival after bone sarcoma lung metastasectomy is encouraging. In our series, DFI and DFI2 were identified as the only prognostic factors.
authors.affiliation: Department of General Thoracic Surgery, Clinica Universidad de Navarra, Pamplona, Spain. cegarciaf@unav.es
authors.forename: Carlos E
authors.initials: CE
authors.lastname: García Franco
authors.forename: Wenceslao
authors.initials: W
authors.lastname: Torre
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamura
authors.forename: Francisco
authors.initials: F
authors.lastname: Guillén-Grima
authors.forename: Mikel
authors.initials: M
authors.lastname: San-Julian
authors.forename: Salvador
authors.initials: S
authors.lastname: Martin-Algarra
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Pardo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012509:Sarcoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult