• Journal of Chest Surgery
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• v.40 no.9
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• pp.607-612
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• 2007

Background: Surgical resection is a standard treatment for pulmonary metastases in patients with osteosarcoma, but the role of performing repeated resections is not clear. This study was designed to clarify the feasibility of performing a repeated pulmonary metastasectomy and the prognostic factors for pulmonary metastases in patients with osteosarcoma. Material and Method: Between January 1990 and July 2005, 62 patients with osteosarcoma were diagnosed with pulmonary metastases and 36 patients underwent pulmonary resection. We reviewed the patients retrospectively. Result: The total number of pulmonary metastasectomies was 62 in 30 patients. Among 36 patients, 18 had a second metastasectomy, 7 had a third metastasectomy, and one patient had a fourth metastasectomy. There was no distinctive difference between the first and second metastatectomy in terms of median survival time, and the 3-year and 5-year survival rate (first resection: 20.5 months, 32.0% and 29,4%; second resection: 11.3 months, 34.9% and 34.%). However, the median survival time (7.1 months) was shorter in patients with a third metastatectomy than in patients with one metastatectomy (p=0.01). In long-term survivors, the number of female patients, patients with a disease free time longer than 12 months, patients with a single metastasis and patients with anatomic resection was larger when compared to non-long term survivors, but showed no statistical significance. Conclusion: Repeated pulmonary metastasectomy is expected to prolong survival time in patients with osteosarcoma, and is expected to increase long-term survival in selected cases. Further studies with a large number of patients are necessary.

• Journal of Hospice and Palliative Care
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• v.17 no.1
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• pp.27-33
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• 2014

Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.