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Current surgical management of children with osteosarcoma and pulmonary metastatic disease: A survey of the American Pediatric Surgical Association.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2021 Feb; Vol. 56 (2), pp. 282-285. Date of Electronic Publication: 2020 Oct 06. - Publication Year :
- 2021
-
Abstract
- Background: Rates of long-term survival for children with pulmonary metastatic osteosarcoma are low, and complete surgical resection of all visible pulmonary metastases is necessary for long term survival. Surgical approaches for metastasectomy include thoracotomy and thoracoscopy, with the approach chosen influenced by training and institutional bias. Thoracotomy with manual palpation of lung surfaces can identify nodules not seen on preoperative imaging, but no clear survival benefit has been demonstrated compared to complete thoracoscopic resection of all visible nodules.<br />Methods: All member of the American Pediatric Surgical Association were surveyed, and 204 members responded.<br />Results: Thoracoscopy was the preferred approach of 34% of surgeons for patients with 3 unilateral nodules but only 21% for those with 5 unilateral nodules. Hospital volume did not correlate with operative approach. Localization strategies are used by 37% of surgeons who prefer thoracotomy and 64% who prefer thoracoscopy. Importantly, the vast majority of responding surgeons (84%) expressed a willingness to participate in a randomized controlled trial of thoracotomy versus thoracoscopy.<br />Conclusion: Findings of this survey of North American pediatric surgeons confirm both the need for, and interest in, a prospective trial to define optimal surgical management of children with osteosarcoma with limited pulmonary metastasis.<br />Level of Evidence: V.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Child
Health Care Surveys
Humans
Prospective Studies
Randomized Controlled Trials as Topic
Retrospective Studies
Thoracoscopy
Thoracotomy
United States
Bone Neoplasms pathology
Bone Neoplasms surgery
Lung Neoplasms mortality
Lung Neoplasms secondary
Lung Neoplasms surgery
Metastasectomy methods
Metastasectomy mortality
Osteosarcoma mortality
Osteosarcoma pathology
Osteosarcoma surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 56
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33558032
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2020.09.060