We analyzed survival rates and the prognostic factors of pulmonary metastases from osteosarcoma.

Between 1989 and 2001, of 312 patients who were diagnosed and treated for osteosarcoma in our institute, 35 patients with pulmonary metastases were included in the present study. We examined the overall survival rates and analyzed prognostic factors, such as age, gender, chemotherapeutic response, number of the pulmonary lesions, and disease-free interval.

Overall 3-year and 5-year survival rates were 62.3% and 39.3%. Patients treated with thoracotomy and chemotherapy seemed to survive longer than patients without thoracic surgery. In the thoracostomy group, the degree of tumor necrosis after neoadjuvant chemotherapy, the number of metastatic nodules, and the tumor free interval were meaningful factors of survival.

In osteosarcoma with pulmonary metastasis, complete metastatectomy and intensive postoperative chemotherapy can improve survival in selected patients.