Metachronous pulmonary metastases resection in patients with Ewing's sarcoma initially treated with adjuvant or neoadjuvant chemotherapy

55 patients with Ewing's sarcoma of bone, treated at our Institution with adjuvant or neoadjuvant chemotherapy between 1972 and 1990, relapsed with pulmonary metastases alone. 12 of these patients-selected according to their long disease-free interval before relapse, monolaterality of the lesions, small numbers of metastatic nodules, resectability and refusal to undergo further chemotherapic treatments-were treated with surgical resection of the metastatic lesions and with no additional radio- or chemotherapy. At a follow-up ranging between 3 and 14 years (mean 9 years), 5 of these 12 patients (42%), were continuously free of disease, whereas the remaining 7 patients died with uncontrolled disease 12-39 months (mean 22 months) after thoracotomy. These results seem to indicate that an aggressive surgical approach should be considered for a selected group of Ewing's sarcoma patients who relapse with only lung metastases.