Ahmed Gehad, Elshafiey Maged, Romeih Marwa, Kamel Ahmed, Elgammal Ahmed, Salama Asmaa, AboTabl Yomna, Taher Mohammad
Department of General Surgery, Faculty of Medicine, Helwan University, Cairo, Egypt.
Children's Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt.
Discov Oncol. 2025 May 9;16(1):705. doi: 10.1007/s12672-025-02446-x.
Most metastatic osteosarcoma pulmonary nodules exist in the periphery of the lung, while other lesions are close to the airway and vascular branches in the center. Central lesions require anatomical resection. However, there is a scarcity of data on the prognostic value of the central location of pulmonary metastasis in osteosarcoma.
We reviewed the medical records of osteosarcoma patients with metastasectomy between January 2009 and June 2022. The central lesions were identified as lesions requiring lobectomy or segmentectomy. We divided our cohort into Group A (peripheral lesion) and Group B (central lesion). The primary outcome measures were overall survival (OS) and postmetastasectomy event-free survival (PMEFS).
We identified a total of 204 osteosarcoma patients with pulmonary metastases. Among them, 162 patients underwent metastasectomy: Group A (n = 128, 80.6%) and Group B (n = 34, 19.4%). Group A had a 5-year overall survival rate (OS) of 36.6% ± 5.7%, whereas Group B had a 5-year overall survival rate of 17.5% ± 8.5%, with (p = 0.048). The 3-year PMEFS for peripheral and central lesions was 25.7 ± 5.1 and 11.8 ± 7.1, respectively, with (p = 0.034).
In Osteosarcoma patients who underwent metastasectomy, central pulmonary nodules are associated with lower OS and PMEFS. We recommend, however, to keep offering these patients the option of metastasectomy as a predictor of survival until a more effective treatment is approved.
大多数转移性骨肉瘤肺结节位于肺周边，而其他病灶靠近肺中央的气道和血管分支。中央病灶需要进行解剖性切除。然而，关于骨肉瘤肺转移中央位置的预后价值的数据较少。
我们回顾了2009年1月至2022年6月间接受转移灶切除术的骨肉瘤患者的病历。中央病灶被定义为需要进行肺叶切除术或肺段切除术的病灶。我们将队列分为A组（周边病灶）和B组（中央病灶）。主要观察指标为总生存期（OS）和转移灶切除术后无事件生存期（PMEFS）。
我们共确定了204例发生肺转移的骨肉瘤患者。其中，162例患者接受了转移灶切除术：A组（n = 128，80.6%）和B组（n = 34，19.4%）。A组的5年总生存率为36.6%±5.7%，而B组的5年总生存率为17.5%±8.5%，（p = 0.048）。周边和中央病灶的3年PMEFS分别为25.7±5.1和11.8±7.1，（p = 0.034）。
在接受转移灶切除术的骨肉瘤患者中，肺中央结节与较低的OS和PMEFS相关。然而，我们建议在批准更有效的治疗方法之前，继续为这些患者提供转移灶切除术作为生存预测指标的选择。
