PURPOSE: The specific aims of this study were to improve event-free survival (EFS) in patients with newly diagnosed nonmetastatic osteosarcoma of an extremity using the histologic response to neoadjuvant chemotherapy to determine postoperative chemotherapy; to evaluate a uniform histologic grading system that measures tumor response; and to identify patient characteristics that might influence EFS and survival. PATIENTS AND METHODS: Two hundred sixty-eight patients with nonmetastatic osteosarcoma of the extremity were entered between August 1983 and October 1986. Preoperative chemotherapy consisted of four courses of high-dose methotrexate (MTX) and one course of bleomycin, cyclophosphamide, and dactinomycin (BCD). Histologic response to preoperative chemotherapy was determined by morphometric analysis. Good histologic responders (< 5% residual viable tumor) were treated postoperatively with MTX, BCD, and doxorubicin (DOX); poor histologic responders were treated with BCD, DOX, and cisplatin (CDDP). RESULTS: The 8-year EFS and survival rates were 53% and 60%, respectively. Two hundred six patients had their tumors assessed for histologic response: 28% displayed a good histologic response to preoperative chemotherapy. Good histologic responders had an 8-year postoperative EFS rate of 81% and survival rate of 87%; those with a poor histologic response had an 8-year postoperative EFS rate of 46% and survival rate of 52%. A primary tumor site in the proximal humerus or proximal femur and an elevated serum alkaline phosphatase level were associated with an increased risk of an adverse event, whereas the type of surgical procedure was not. CONCLUSION: EFS and survival appear to be directly related to histologic response to neoadjuvant chemotherapy.
PURPOSE: The specific aims of this study were to improve event-free survival (EFS) in patients with newly diagnosed nonmetastatic osteosarcoma of an extremity using the histologic response to neoadjuvant chemotherapy to determine postoperative chemotherapy; to evaluate a uniform histologic grading system that measures tumor response; and to identify patient characteristics that might influence EFS and survival. PATIENTS AND METHODS: Two hundred sixty-eight patients with nonmetastatic osteosarcoma of the extremity were entered between August 1983 and October 1986. Preoperative chemotherapy consisted of four courses of high-dose methotrexate (MTX) and one course of bleomycin, cyclophosphamide, and dactinomycin (BCD). Histologic response to preoperative chemotherapy was determined by morphometric analysis. Good histologic responders (< 5% residual viable tumor) were treated postoperatively with MTX, BCD, and doxorubicin (DOX); poor histologic responders were treated with BCD, DOX, and cisplatin (CDDP). RESULTS: The 8-year EFS and survival rates were 53% and 60%, respectively. Two hundred six patients had their tumors assessed for histologic response: 28% displayed a good histologic response to preoperative chemotherapy. Good histologic responders had an 8-year postoperative EFS rate of 81% and survival rate of 87%; those with a poor histologic response had an 8-year postoperative EFS rate of 46% and survival rate of 52%. A primary tumor site in the proximal humerus or proximal femur and an elevated serum alkaline phosphatase level were associated with an increased risk of an adverse event, whereas the type of surgical procedure was not. CONCLUSION: EFS and survival appear to be directly related to histologic response to neoadjuvant chemotherapy.
Authors: Jennifer Worch; Katherine K Matthay; John Neuhaus; Robert Goldsby; Steven G DuBois Journal: Pediatr Blood Cancer Date: 2010-08 Impact factor: 3.167
Authors: Fariba Navid; Victor M Santana; Michael Neel; M Beth McCarville; Barry L Shulkin; Jianrong Wu; Catherine A Billups; Shenghua Mao; Vinay M Daryani; Clinton F Stewart; Michelle Kunkel; Wendene Smith; Deborah Ward; Alberto S Pappo; Armita Bahrami; David M Loeb; Jennifer Reikes Willert; Bhaskar N Rao; Najat C Daw Journal: Int J Cancer Date: 2017-07-03 Impact factor: 7.396
Authors: Gatien Moriceau; Benjamin Ory; Laura Mitrofan; Chiara Riganti; Frédéric Blanchard; Régis Brion; Céline Charrier; Séverine Battaglia; Paul Pilet; Marc G Denis; Leonard D Shultz; Jukka Mönkkönen; Françoise Rédini; Dominique Heymann Journal: Cancer Res Date: 2010-10-22 Impact factor: 12.701
Authors: James C Davis; Najat C Daw; Fariba Navid; Catherine A Billups; Jianrong Wu; Armita Bahrami; Jesse J Jenkins; Scott E Snyder; Wilburn E Reddick; Victor M Santana; M Beth McCarville; Junyu Guo; Barry L Shulkin Journal: J Nucl Med Date: 2017-06-13 Impact factor: 10.057