PURPOSE: To evaluate the impact of patient, tumor, and treatment-related factors on outcome in unselected patients with recurrent osteosarcoma. PATIENTS AND METHODS: Five hundred seventy-six consecutive patients who had achieved a first complete surgical remission (CR) during combined-modality therapy on neoadjuvant Cooperative Osteosarcoma Study Group (COSS) protocols and then developed recurrent osteosarcoma were analyzed (median time from biopsy to relapse, 1.6 years; range, 0.1 to 14.3 years). There were 501 patients with metastases, 44 with local recurrences, and 31 with both. Metastases involved lungs (469 patients), bones (90 patients), and/or other sites (54 patients). RESULTS: After a median follow-up of 1.2 years for all patients and 4.2 years for survivors, actuarial overall survival (OS) rates at 2, 5, and 10 years were 0.38, 0.23, and 0.18, respectively. Five-year OS was 0.39 for 339 patients with and 0.00 for 229 patients without a second surgical CR (P < .0001). A long time to relapse, a solitary lesion, and, in the case of pulmonary metastases, unilateral disease and the absence of pleural disruption, were of positive prognostic value in uni- and multivariate analyses, as were a second surgical CR and the use of second-line chemotherapy. Radiotherapy was associated with moderately prolonged survival in patients without a second CR. The very limited prognostic differences associated with the use of second-line chemotherapy appeared to be more pronounced with polychemotherapy. CONCLUSION: Time to relapse and tumor burden correlate with postrelapse outcome in osteosarcoma. Complete surgery is an essential component of curative second-line therapy. Chemotherapy, particularly chemotherapy with more than one agent, may contribute to limited improvements in outcome.
PURPOSE: To evaluate the impact of patient, tumor, and treatment-related factors on outcome in unselected patients with recurrent osteosarcoma. PATIENTS AND METHODS: Five hundred seventy-six consecutive patients who had achieved a first complete surgical remission (CR) during combined-modality therapy on neoadjuvant Cooperative Osteosarcoma Study Group (COSS) protocols and then developed recurrent osteosarcoma were analyzed (median time from biopsy to relapse, 1.6 years; range, 0.1 to 14.3 years). There were 501 patients with metastases, 44 with local recurrences, and 31 with both. Metastases involved lungs (469 patients), bones (90 patients), and/or other sites (54 patients). RESULTS: After a median follow-up of 1.2 years for all patients and 4.2 years for survivors, actuarial overall survival (OS) rates at 2, 5, and 10 years were 0.38, 0.23, and 0.18, respectively. Five-year OS was 0.39 for 339 patients with and 0.00 for 229 patients without a second surgical CR (P < .0001). A long time to relapse, a solitary lesion, and, in the case of pulmonary metastases, unilateral disease and the absence of pleural disruption, were of positive prognostic value in uni- and multivariate analyses, as were a second surgical CR and the use of second-line chemotherapy. Radiotherapy was associated with moderately prolonged survival in patients without a second CR. The very limited prognostic differences associated with the use of second-line chemotherapy appeared to be more pronounced with polychemotherapy. CONCLUSION: Time to relapse and tumor burden correlate with postrelapse outcome in osteosarcoma. Complete surgery is an essential component of curative second-line therapy. Chemotherapy, particularly chemotherapy with more than one agent, may contribute to limited improvements in outcome.
Authors: Rajaram Nagarajan; Anmmd Kamruzzaman; Kirsten K Ness; Victoria G Marchese; Charles Sklar; Ann Mertens; Yutaka Yasui; Leslie L Robison; Neyssa Marina Journal: Cancer Date: 2010-10-04 Impact factor: 6.860
Authors: Gangxiong Huang; Ling Yu; Laurence Jn Cooper; Mario Hollomon; Helen Huls; Eugenie S Kleinerman Journal: Cancer Res Date: 2011-11-10 Impact factor: 12.701
Authors: P M Anderson; P Meyers; E Kleinerman; K Venkatakrishnan; D P Hughes; C Herzog; W Huh; R Sutphin; Y M Vyas; V Shen; A Warwick; N Yeager; C Oliva; B Wang; Y Liu; A Chou Journal: Pediatr Blood Cancer Date: 2013-08-31 Impact factor: 3.167
Authors: Roelof Koster; Orestis A Panagiotou; William A Wheeler; Eric Karlins; Julie M Gastier-Foster; Silvia Regina Caminada de Toledo; Antonio S Petrilli; Adrienne M Flanagan; Roberto Tirabosco; Irene L Andrulis; Jay S Wunder; Nalan Gokgoz; Ana Patiño-Garcia; Fernando Lecanda; Massimo Serra; Claudia Hattinger; Piero Picci; Katia Scotlandi; David M Thomas; Mandy L Ballinger; Richard Gorlick; Donald A Barkauskas; Logan G Spector; Margaret Tucker; D Hicks Belynda; Meredith Yeager; Robert N Hoover; Sholom Wacholder; Stephen J Chanock; Sharon A Savage; Lisa Mirabello Journal: Int J Cancer Date: 2017-12-23 Impact factor: 7.396
Authors: Richard Gorlick; Katherine Janeway; Stephen Lessnick; R Lor Randall; Neyssa Marina Journal: Pediatr Blood Cancer Date: 2012-12-19 Impact factor: 3.167