TY - JOUR
T1 - Long-term pulmonary function after metastasectomy for childhood osteosarcoma
T2 - A report from the st Jude lifetime cohort study
AU - Denbo, Jason W.
AU - Zhu, Liang
AU - Srivastava, Deokumar
AU - Stokes, Dennis C.
AU - Srinivasan, Saumini
AU - Hudson, Melissa M.
AU - Ness, Kirsten K.
AU - Robison, Leslie L.
AU - Neel, Michael
AU - Rao, Bhaskar
AU - Navid, Fariba
AU - Davidoff, Andrew M.
AU - Green, Daniel M.
PY - 2014/8
Y1 - 2014/8
N2 - 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.
AB - 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.
KW - Abbreviations and Acronyms
KW - FVC
KW - PFT
KW - SJLIFE
KW - St Jude Lifetime Cohort Study
KW - TLC
KW - forced expiratory volume in 1 second
KW - forced vital capacity
KW - pulmonary function test
KW - single breath diffusion capacity for carbon monoxide corrected for hemoglobin
KW - total lung capacity
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U2 - 10.1016/j.jamcollsurg.2013.12.064
DO - 10.1016/j.jamcollsurg.2013.12.064
M3 - Article
C2 - 24795268
AN - SCOPUS:84904645695
VL - 219
SP - 265
EP - 271
JO - Surgery Gynecology and Obstetrics
JF - Surgery Gynecology and Obstetrics
SN - 1072-7515
IS - 2
ER -