Reexamination and Therapeutic Problems of Osteosarcomas

Recently, it has been shown that osteosarcomas can be classified into various subtypes, including a low-grade central type. Twenty-two patients with osteosarcoma were reexamined to clarify their therapeutic problems. Four of the twenty-two cases were histologically diagnosed as having different tumors. Two of the four neoplasms were previously diagnosed as low-grade central osteosarcomas, but this was changed to dysplasia and fibrous histiocytoma from the biopsy and surgical specimens. Two remaining cases which were first diagnosed as osteosarcomas after surgery and autopsy were further differentiatid as being high-grade osteosarcomas. Nine patients developed pulmonary metastases leading to death. The surgical effects of pulmonary metastasis correlate well with the occurring periods. We found that the time between the initial surgery for the osteosarcoma and that of the second surgery for metastasis correlated well with survival. For example, if surgery was required to treat the pulmonary metastasis within 2 years from the initial surgery, there was a Slight effect on the patients prognosis. However if metastatic lesions occurred more than 2 years after the primary treatment given for the osteosarcoma, then there was a longer survival period due to the pulmonary partial resection.