Variability in the reported management of pulmonary metastases in osteosarcoma.
Bottom Line: Thoracotomy was the preferred technique for surgical resection.When only unilateral findings were present, the majority of physicians did not explore the contralateral lung.The majority of respondents did not recommend resection if the pulmonary nodule disappeared following chemotherapy.
Affiliation: Division of Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.Show MeSH
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Mentions: If the survey participants chose to defer management of the nodules until after neoadjuvant chemotherapy or after completion of all planned chemotherapy, they were told that the primary tumor had >90% necrosis and presented with additional scenarios of the nodule remaining unchanged, decreased in size, or disappeared altogether. Of the 166 respondents who chose to defer management of a solitary 2 cm nodule, 78% believed management was complete when the nodule disappeared on repeat imaging. This practice was not statistically significantly different in the subcentimeter or multiple bilateral nodules scenarios (80% and 72%, respectively) (Figs.1 and 2).
Affiliation: Division of Pediatric Hematology/Oncology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.