BACKGROUND: The authors present the long-term follow-up (>25 years) data from 1 of the original prospective, randomized trials that compared adjuvant chemotherapy with expectant management in patients with high-grade, localized osteosarcoma. In addition, the value of pathologic necrosis induced by a single cycle of neoadjuvant chemotherapy was analyzed as a predictive marker of disease-free and overall survival. METHODS:Fifty-nine patients with high-grade, localized osteosarcoma were enrolled in a prospective trial that was performed between 1981 and 1984 at the University of California-Los Angeles (UCLA). Patients were randomized to receive either adjuvant chemotherapy or observation after surgical resection. Long-term outcomes, follow-up, and pathologic review of all available histologic sections were performed. RESULTS: The 25-year disease-free survival rate was 28% for patients who received adjuvant chemotherapy compared with 15% for the untreated patients (P = .02). The overall survival rate at 25 years was also significantly higher for treated patients versus untreated patients (38% vs 15%; P = .02). Tumor necrosis >90% after a single round of chemotherapy was a statistically significant predictor of overall survival and disease-free survival for patients who received adjuvant therapy (164 months vs 65 months [P = .04] and 141 months vs 14 months [P < .01], respectively). CONCLUSIONS:Patients with high-grade, localized osteosarcoma who receivedadjuvant chemotherapy after undergoing definitive surgical resection had a statistically significant benefit in disease-free and overall survival that was maintained through 25 years. Tumor necrosis after just 1 cycle of neoadjuvant chemotherapy and radiation was predictive of overall survival and disease-free survival in patients who received adjuvant chemotherapy.
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BACKGROUND: The authors present the long-term follow-up (>25 years) data from 1 of the original prospective, randomized trials that compared adjuvant chemotherapy with expectant management in patients with high-grade, localized osteosarcoma. In addition, the value of pathologic necrosis induced by a single cycle of neoadjuvant chemotherapy was analyzed as a predictive marker of disease-free and overall survival. METHODS: Fifty-nine patients with high-grade, localized osteosarcoma were enrolled in a prospective trial that was performed between 1981 and 1984 at the University of California-Los Angeles (UCLA). Patients were randomized to receive either adjuvant chemotherapy or observation after surgical resection. Long-term outcomes, follow-up, and pathologic review of all available histologic sections were performed. RESULTS: The 25-year disease-free survival rate was 28% for patients who received adjuvant chemotherapy compared with 15% for the untreated patients (P = .02). The overall survival rate at 25 years was also significantly higher for treated patients versus untreated patients (38% vs 15%; P = .02). Tumor necrosis >90% after a single round of chemotherapy was a statistically significant predictor of overall survival and disease-free survival for patients who received adjuvant therapy (164 months vs 65 months [P = .04] and 141 months vs 14 months [P < .01], respectively). CONCLUSIONS:Patients with high-grade, localized osteosarcoma who received adjuvant chemotherapy after undergoing definitive surgical resection had a statistically significant benefit in disease-free and overall survival that was maintained through 25 years. Tumor necrosis after just 1 cycle of neoadjuvant chemotherapy and radiation was predictive of overall survival and disease-free survival in patients who received adjuvant chemotherapy.
Authors: Ya Zhang; Jingqing Yang; Na Zhao; Cao Wang; Santosh Kamar; Yonghong Zhou; Zewei He; Jifei Yang; Bin Sun; Xiaoqian Shi; Lei Han; Zuozhang Yang Journal: Oncol Lett Date: 2018-09-12 Impact factor: 2.967
Authors: Yoshiyuki Suehara; Deepu Alex; Anita Bowman; Sumit Middha; Ahmet Zehir; Debyani Chakravarty; Lu Wang; George Jour; Khedoudja Nafa; Takuo Hayashi; Achim A Jungbluth; Denise Frosina; Emily Slotkin; Neerav Shukla; Paul Meyers; John H Healey; Meera Hameed; Marc Ladanyi Journal: Clin Cancer Res Date: 2019-06-07 Impact factor: 12.531
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