The primary site of metastasis of osteosarcoma is the lung. Even if a primary lesion was completely removed by radical surgery, more than 90% of the patients died of pulmonary metastasis in one to two years in the past. A control of osteosarcoma depends upon the prevention and treatment of its pulmonary metastasis. An introduction of chemotherapy consisting mainly of adriamycin and high-dose methotrexate dramatically improved the prognosis of osteosarcoma. We analyzed the clinical data, and gross as well as histopathologic post mortem findings, in 161 cases without chemotherapy and 42 cases with systemic adjuvant chemotherapy. Based on these analysis, we tried to clarify the nature of pulmonary metastasis of osteosarcoma and to evaluate its response to treatment from a standpoint of clinical pathology, hoping that this would yield a clue to future treatment of osteosarcoma.
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