The role of thoracic surgery in the management of metastatic osteogenic sarcoma.

Fifty percent of patients with osteogenic sarcoma who develop pulmonary metastases are salvageable with continued effective chemotherapy and thoracotomies, as long as good local control is achieved in the primary tumor. In patients presenting with simultaneous primary tumor and pulmonary metastatic disease, the cure rate is potentially as high as it is in those patients who present with primary tumor alone. However, in the latter patients, curative surgery must be done to obtain permanent local control for the primary tumor, and thoracotomy must be performed to remove residual disease to ensure against recurrent disease.