{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:25:52Z","timestamp":1791671152211,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate patient and tumour characteristics, treatment and their impact on survival in patients with a solitary pulmonary metastasis at first relapse of high\u2010grade osteosarcoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Two\u2010hundred and nineteen consecutive patients who had achieved a complete surgical remission and then developed a solitary pulmonary metastasis at first recurrence of high\u2010grade osteosarcoma were retrospectively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two hundred and three (94.9%) of 214 patients achieved a second complete remission. After a median time from initial diagnosis of osteosarcoma to first relapse of 2.3\u2009years (range, 0.3\u201318.8\u2009years), actuarial post\u2010relapse overall survival after 2 and 5\u2009years was 72.0% and 51.2%. Post\u2010relapse event\u2010free survival was 39.1% and 31.1%. Median follow\u2010up time was 3.2\u2009years (range, 0.1\u201329.4\u2009years). A longer time until first relapse and diagnosis due to imaging were positive prognostic factors in uni\u2010 and multivariate analyses, as were a second complete surgical remission and, in regard to death, the absence of a subsequent relapse. The use of salvage chemotherapy and radiotherapy were not associated with patient outcomes, nor was the surgical approach (thoracoscopy vs. thoracotomy) nor the exploration (uni\u2010 vs. bilateral).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately half of the patients who experience a solitary pulmonary relapse at first recurrence of osteosarcoma remain alive 5\u2009years after this first relapse. Only one third will remain disease\u2010free. A complete surgical resection of the lesion is essential for long\u2010term survival while relapse chemotherapy does not seem to improve survival. Innovative therapies are required to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.6409","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T07:55:17Z","timestamp":1691394917000},"page":"18219-18234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Solitary pulmonary metastases at first recurrence of osteosarcoma: Presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-8830","authenticated-orcid":false,"given":"Vanessa L.","family":"Mettmann","sequence":"first","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"},{"name":"Medical Faculty Heidelberg Heidelberg University  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Baumhoer","sequence":"additional","affiliation":[{"name":"Bone Tumour Reference Centre, Institute of Medical Genetics and Pathology University Hospital Basel and University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2144-3153","authenticated-orcid":false,"given":"Stefan S.","family":"Bielack","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"},{"name":"Department for Paediatric Haematology and Oncology University's Children's Hospital Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Blattmann","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godehard","family":"Friedel","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery University of Tubingen, Faculty of Science  Tubingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thekla","family":"von Kalle","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre Institute of Radiology  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Kager","sequence":"additional","affiliation":[{"name":"St. Anna Kinderspital University Hospital for Paediatric and Adolescent Medicine of the Medical University, and St. Anna Children's Cancer Research Institute (CCRI)  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kevric","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Nathrath","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Children's Cancer Research Centre, Klinikum rechts der Isar Technical University of Munich, School of Medicine  Munich Germany"},{"name":"Paediatric Haematology and Oncology, Klinikum Kassel  Kassel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Sorg","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"D\u00fcrken","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Mannheim University Hospital  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hecker\u2010Nolting","sequence":"additional","affiliation":[{"name":"Klinikum Stuttgart \u2010 Olgahospital, Stuttgart Cancer Centre, Paediatrics 5 (Oncology, Haematology, Immunology)  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"ErdmannFKP GrabowD SpixC.German Childhood Cancer Registry\u2013Annual Report 2019 (1980\u20132018). 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