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Ann Thorac Surg 1980;29:410-414
© 1980 The Society of Thoracic Surgeons

Articles

Pulmonary Metastases in Childhood Sarcoma

Bradley M. Rodgers, M.D.*, James L. Talbert, M.D., James A. Alexander, M.D.

University of Florida College of Medicine, Divisions of Thoracic and Pediatric Surgery, Department of Surgery, Gainesville, FL

Accepted for publication December 13, 1979.

* Address reprint requests to Dr. Rodgers, Box J-286, JHM Health Center, Gainesville, FL 32610

A retrospective analysis of 56 patients less than 19 years old with pulmonary metastases from previously diagnosed sarcomas was performed. Thirty patients had primary osteogenic sarcoma. Eighteen of them underwent a total of 37 thoracotomies. Overall survival was 20%. Twelve patients were noted to have metastatic Wilms' tumor, and 5 of them underwent 7 thoracotomies. This group had a 25% overall survival. Six patients had pulmonary metastases from Ewing's sarcoma. Four of these required pulmonary resection. The overall survival in these patients was 50%. The remaining 8 patients had pulmonary resection for various soft tissue malignancies, with an overall survival of 50%. The results of this review indicate a role for aggressive pulmonary resection in patients in whom the primary tumor is controlled and there is no other evidence of metastatic disease. The frequency of bilaterality and multicentric implants in patients with osteogenic sarcoma and Wilms' tumor suggest the efficacy of a median sternotomy approach in these patients.




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