Long-term pulmonary function after metastasectomy for childhood osteosarcoma: A report from the st Jude lifetime cohort study

Jason W. Denbo, Liang Zhu, Deokumar Srivastava, Dennis C. Stokes, Saumini Srinivasan, Melissa M. Hudson, Kirsten K. Ness, Leslie L. Robison, Michael Neel, Bhaskar Rao, Fariba Navid, Andrew M. Davidoff, Daniel M. Green

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Background Complete resection of lung metastases improves survival in patients with osteosarcoma. We evaluated the long-term effect of metastasectomy on pulmonary function of patients treated for osteosarcoma during childhood. Study Design We reviewed the medical records of patients who had pulmonary function tests (PFTs) after metastasectomy for osteosarcoma. Patient, tumor, and treatment variables were abstracted along with PFTs. The PFTs were recorded as a percentage of predicted value and were classified as abnormal for forced vital capacity (FVC) < 80%, forced expiratory volume in 1 second (FEV1) < 80%, total lung capacity (TLC) < 75%, and single breath diffusion capacity for carbon monoxide corrected for hemoglobin (DLCOcorr) < 75%. Results Twenty-one patients had PFTs performed during follow-up. Mean age at diagnosis of osteosarcoma was 13.2 ± 4.7 years (SD). Fifteen patients had a single thoracotomy, and 6 patients had ≤2 thoracotomies (range 2 to 6). Eighty lesions were resected. Nine patients had ≥2 lesions resected and 12 patients had >2 lesions (range 3 to 12) resected. Mean time from the last surgical procedure to measurement of PFTs was 20.3 ± 9.0 years (SD). Total lung capacity was abnormal for 28.6%, DLCObsubesub for 47.4%, FVC for 40%, and FEVbsubesub for 47.6% of the cohort members. Individual PFTs were abnormal in 13.3% (TLC) to 46.7% (DLCObsubesub) of patients who had 1 thoracotomy and in 50.0% (DLCO bsubesub) to 66.7% (FEVbsubesub, TLC) of patients with ≤2 thoracotomies. The number of thoracotomies was associated with abnormal TLC (p = 0.03). Conclusions Patients who underwent pulmonary metastasectomy for osteosarcoma as children often had abnormal PFTs on long-term follow-up, but the reduction in lung volumes and DLCO;bsubesub was relatively mild. Multiple thoracotomies predicted greater impairment of pulmonary function.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalJournal of the American College of Surgeons
Volume219
Issue number2
DOIs
StatePublished - Aug 2014

Keywords

  • Abbreviations and Acronyms
  • FVC
  • PFT
  • SJLIFE
  • St Jude Lifetime Cohort Study
  • TLC
  • forced expiratory volume in 1 second
  • forced vital capacity
  • pulmonary function test
  • single breath diffusion capacity for carbon monoxide corrected for hemoglobin
  • total lung capacity

Fingerprint Dive into the research topics of 'Long-term pulmonary function after metastasectomy for childhood osteosarcoma: A report from the st Jude lifetime cohort study'. Together they form a unique fingerprint.

  • Cite this

    Denbo, J. W., Zhu, L., Srivastava, D., Stokes, D. C., Srinivasan, S., Hudson, M. M., Ness, K. K., Robison, L. L., Neel, M., Rao, B., Navid, F., Davidoff, A. M., & Green, D. M. (2014). Long-term pulmonary function after metastasectomy for childhood osteosarcoma: A report from the st Jude lifetime cohort study. Journal of the American College of Surgeons, 219(2), 265-271. https://doi.org/10.1016/j.jamcollsurg.2013.12.064