Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Introduction: Metastatic tumors account for approximately 80% of all lung tumors in children. Although a wide variety of sarcomas and embryonal tumors of childhood produce lung metastases in children, Wilm{u2019}s tumor and osteosarcoma are the most frequent. While some metastatic lung nodules are excised for diagnosis and staging, others are removed as a part of oncologic management to achieve long-term survival and effect cure. Aim of Work: Assessment of prognostic factors of pulmonary metastatectomy in pediatric solid tumors as age, number, size, site, laterality, resectability of pulmonary nodules and number of Thoracotomies. Calculate overall survival (OS) among Patients who underwent pulmonary metastatectomy. Correlation of different prognostic factors with overall survival. Patients and Methods: Retrospective study included all patients with metastatic solid tumors to lungs who were treated at pediatric oncology and surgical departments, national Cancer Institute, Cairo University from 2008 to 2014 with resectable lung disease based on C.T chest and lung is the only site of metastasis. Results: Fifty five patients were included,43 were Osteosarcoma (78.2{u2105}), 5 cases Synovial sarcoma(9.1{u2105}),2 cases Rhabdomyosarcoma (3.6{u2105}),2 cases Ewing Sarcoma(3.6{u2105}),2 cases Germ cell tumor (3.6{u2105})and 1 case was Wilm{u2019}s tumor(1.8{u2105}).There were 30 males (54.5{u2105})and 25 female 45.5%.The mean age was 15 years ranging from (4.5- 23) years. The site of primary disease was at lower limbs in 43 patients (78.2%), upper limbs in 5 patients and other sites as anterior chest wall, axillary area, paraspinal area and kidney. All of them underwent complete surgical resection of the primary disease with negative margin, 22 patients did amputation (all of them were osteosarcoma except one case was synovial sarcoma) with tumor necrosis less than 90% in 40 cases

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