Current surgical management of children with osteosarcoma and pulmonary metastatic disease: a survey of the AMERICAN pediatric surgical association

Survey of 204 APSA members reveals divided practice patterns in surgical management of pediatric osteosarcoma pulmonary metastases, with thoracoscopy preferred by 21-34% depending on nodule burden. Despite lack of consensus on optimal approach (thoracotomy with palpation vs. thoracoscopic resection), 84% of surgeons support a randomized trial to establish evidence-based guidelines.