BACKGROUND: The dose intensity of chemotherapy has been described as affecting the outcome of the treatment of a number of different types of tumors. A delay in the resumption of chemotherapy after definitive surgery for the treatment of osteosarcoma can decrease the overall dose intensity. The goal of this study was to assess the prognostic significance of the time to resumption of chemotherapy after definitive surgery in patients with localized osteosarcoma in an extremity. METHODS: The relationships of the time between definitive surgery and resumption of chemotherapy with death and adverse events in 703 patients with a localized resectable osteosarcoma in an extremity (556 treated in the Children's Oncology Group [COG] Study [INT 0133] and 147 treated at five tertiary care cancer centers) were assessed with use of Cox proportional hazards models. RESULTS: The twenty-fifth, fiftieth, and seventy-fifth percentiles of time from definitive surgery to resumption of chemotherapy were twelve, sixteen, and twenty-one days, respectively. Overall survival was poorer for patients who had had a delay of greater than twenty-one days before the resumption of chemotherapy compared with those who had had a shorter delay (hazard ratio = 1.57 [95% confidence interval = 1.04 to 2.36]; p = 0.03). Of seventy-one COG-study patients with postoperative complications, 32% (twenty-three) had a delay of more than twenty-one days before resumption of chemotherapy, but 20% (eighty-nine) of 444 patients with no complications had a similar delay. CONCLUSIONS: In this retrospective analysis, increased time from the definitive surgery to the resumption of chemotherapy was found to be associated with an increased risk of death of patients with localized osteosarcoma in an extremity. Within the limitations of a retrospective study, the data indicate that it is best to resume chemotherapy within twenty-one days after definitive surgery. Surgeons, oncologists, patients, and those responsible for scheduling need to work together to ensure timely resumption of chemotherapy after surgery.
BACKGROUND: The dose intensity of chemotherapy has been described as affecting the outcome of the treatment of a number of different types of tumors. A delay in the resumption of chemotherapy after definitive surgery for the treatment of osteosarcoma can decrease the overall dose intensity. The goal of this study was to assess the prognostic significance of the time to resumption of chemotherapy after definitive surgery in patients with localized osteosarcoma in an extremity. METHODS: The relationships of the time between definitive surgery and resumption of chemotherapy with death and adverse events in 703 patients with a localized resectable osteosarcoma in an extremity (556 treated in the Children's Oncology Group [COG] Study [INT 0133] and 147 treated at five tertiary care cancer centers) were assessed with use of Cox proportional hazards models. RESULTS: The twenty-fifth, fiftieth, and seventy-fifth percentiles of time from definitive surgery to resumption of chemotherapy were twelve, sixteen, and twenty-one days, respectively. Overall survival was poorer for patients who had had a delay of greater than twenty-one days before the resumption of chemotherapy compared with those who had had a shorter delay (hazard ratio = 1.57 [95% confidence interval = 1.04 to 2.36]; p = 0.03). Of seventy-one COG-study patients with postoperative complications, 32% (twenty-three) had a delay of more than twenty-one days before resumption of chemotherapy, but 20% (eighty-nine) of 444 patients with no complications had a similar delay. CONCLUSIONS: In this retrospective analysis, increased time from the definitive surgery to the resumption of chemotherapy was found to be associated with an increased risk of death of patients with localized osteosarcoma in an extremity. Within the limitations of a retrospective study, the data indicate that it is best to resume chemotherapy within twenty-one days after definitive surgery. Surgeons, oncologists, patients, and those responsible for scheduling need to work together to ensure timely resumption of chemotherapy after surgery.
Authors: Paul A Meyers; Cindy L Schwartz; Mark Krailo; Eugenie S Kleinerman; Donna Betcher; Mark L Bernstein; Ernest Conrad; William Ferguson; Mark Gebhardt; Allen M Goorin; Michael B Harris; John Healey; Andrew Huvos; Michael Link; Joseph Montebello; Helen Nadel; Michael Nieder; Judith Sato; Gene Siegal; Michael Weiner; Robert Wells; Lester Wold; Richard Womer; Holcombe Grier Journal: J Clin Oncol Date: 2005-03-20 Impact factor: 44.544
Authors: G Bacci; S Ferrari; A Longhi; P Picci; M Mercuri; T A Alvegard; G Saeter; D Donati; M Manfrini; S Lari; A Briccoli; C Forni Journal: J Chemother Date: 2002-04 Impact factor: 1.714
Authors: G Bacci; P Picci; M Avella; D Dallari; S Ferrari; R Prasad; M Di Scioscio; C Malaguti; P Caldora Journal: J Chemother Date: 1990-04 Impact factor: 1.714
Authors: Ian J Lewis; Marianne A Nooij; Jeremy Whelan; Matthew R Sydes; Robert Grimer; Pancras C W Hogendoorn; Muhammad A Memon; Simon Weeden; Barbara M Uscinska; Martine van Glabbeke; Anne Kirkpatrick; Esther I Hauben; Alan W Craft; Antonie H M Taminiau Journal: J Natl Cancer Inst Date: 2007-01-17 Impact factor: 13.506
Authors: George T Calvert; Jennifer Wright; Jayant Agarwal; Kevin B Jones; R Lor Randall Journal: Clin Orthop Relat Res Date: 2015-03 Impact factor: 4.176
Authors: Andrés Redondo; Silvia Bagué; Daniel Bernabeu; Eduardo Ortiz-Cruz; Claudia Valverde; Rosa Alvarez; Javier Martinez-Trufero; Jose A Lopez-Martin; Raquel Correa; Josefina Cruz; Antonio Lopez-Pousa; Aurelio Santos; Xavier García Del Muro; Javier Martin-Broto Journal: Cancer Chemother Pharmacol Date: 2017-10-16 Impact factor: 3.333