This study compares two types of chest surgery for patients with osteosarcoma, a type of bone cancer, that has spread to the lungs. The first method, called thoracotomy, involves a large cut between the ribs to remove the cancer. The second method, thoracoscopy or VATS, uses smaller cuts and a camera to remove the cancer. The aim is to find out which surgery works better.

• The study lasts up to 2 years with follow-up visits.
• Patients may have to provide blood and tissue samples.
• Participants must be under 50 and meet certain health criteria.

Patients are divided into two groups: one will have a thoracotomy and the other thoracoscopy. The study will check which method helps patients live longer without the cancer coming back, and which causes less pain after surgery. It will also look at any surgery complications and overall health after the procedure.