Ninety-seven pulmonary metastatic cases in 141 osteosarcoma from 1960 to 1981 were analysed. The overall cumulative 5-year survival rate of the cases was 38.1%, whereas that of the recent 41 cases with systemic chemotherapy was 56.2%. Eighty percent of pulmonary metastases were found within one year since their first visit to our clinic. It was revealed that there were positive relationship between the doubling time of the pulmonary metastases and the post-metastatic survival (p less than 0.001), and between the period from their first visit to our clinic to metastases and the post-metastatic survival (p less than 0.001). The favorable effects of the systemic chemotherapy using adriamycin, vincristine, methotrexate and cis-platinum were recognized. The thoracotomy revealed effective and five cases are living without disease for average 80.8 months after surgery.

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