METACHRONOUS PULMONARY METASTASES RESECTION IN PATIENTS WITH EWINGS-SARCOMA INITIALLY TREATED WITH ADJUVANT OR NEOADJUVANT CHEMOTHERAPY

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