OBJECTIVE: The combination of surgery and chemotherapy improves the prognosis of @entity1 with @entity421 of the limbs without detectable @entity3 at presentation. However, lung @entity3 are a frequent complication. To evaluate the role of the resection of pulmonary @entity3 of @entity421 of the limbs, we have reviewed our experience with this type of surgery, combined with a multidrug chemotherapy protocol. @entity1 AND METHODS: From January 89 to December 97, 198 @entity1 operated on for @entity421 of the limbs were followed in our centre. Of these, 31 @entity1 (15.7%), with a mean age of 25 years (range 10-54 years), developed lung @entity3 and had undergone 45 thoracotomies. All @entity1 received chemotherapy, followed by resection of metastatic lesions and additional chemotherapy. The mean time interval between resection of the primary @entity5 and the diagnosis of lung @entity3 was 22 months (4-122 months). Eight @entity1 (25.8%) needed more than one (2-4) thoracotomy. The mean time interval between the first and second thoracic surgeries was 9.2 months (2-14 months). RESULTS: There was no operative mortality or major morbidity. During the 45 thoracotomies, five lobectomies and 40 wedge resections were necessary. The mean number of @entity3 resected per thoracotomy was 3.4 (range 1-10). The degree of @entity39 was evaluated by seriated sections for a histologic study. In the end the mean necrotic volume was calculated. A strong correlation was found between the degree of @entity39 of the @entity3 and the need for reoperation for new metastatic lesions, because all the @entity1 who needed more than one operation had less than 80% of @entity39 of @entity3 . The @entity1 were followed for a mean period of 28 months (6-72 months). Ten @entity1 (32.2%) died of related causes at a mean of 19.4 months after thoracic surgery, three of whom had more than one operation. The 3-year survival after metastasectomy was 61%. @entity1 without pulmonary @entity3 had a 3-year survival of 79%. CONCLUSIONS: In @entity1 with lung @entity3 of an @entity421 , the combination of chemotherapy and surgery improves the outcome. In our series the mortality was not influenced by the number or thoracotomies required.

Excision of pulmonary @entity3 of XXXX of the limbs.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumour'] @entity421 :: ('MESH:D012516', 'Disease') :: ['osteogenic sarcoma', 'osteogenic sarcomas'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity421 :: (MESH:D012516,Disease) :: ['osteogenic sarcoma']
