Good prognosis of localized osteosarcoma in young patients treated with limb-salvage surgery and chemotherapy

Background The objective of this report was to estimate long‐term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center. Procedure To evaluate the efficacy of surgery and multiagent chemother...

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Veröffentlicht in:Pediatric blood & cancer 2011-09, Vol.57 (3), p.415-422
Hauptverfasser: Hegyi, Marta, Semsei, Agnes F., Jakab, Zsuzsanna, Antal, Imre, Kiss, Janos, Szendroi, Miklos, Csoka, Monika, Kovacs, Gabor
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container_end_page 422
container_issue 3
container_start_page 415
container_title Pediatric blood & cancer
container_volume 57
creator Hegyi, Marta
Semsei, Agnes F.
Jakab, Zsuzsanna
Antal, Imre
Kiss, Janos
Szendroi, Miklos
Csoka, Monika
Kovacs, Gabor
description Background The objective of this report was to estimate long‐term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center. Procedure To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.8 ± 3.6 years) treated at the Second Department of Pediatrics in Budapest between 1988 and 2006. Demographic parameters, tumor‐related and treatment‐related variables, response, overall survival (OS) and event‐free survival (EFS) were analyzed. Results The 5‐year OS was 68% and 5‐year EFS was 62%. OS of patients without metastasis was 79%, while OS with early metastasis was 17%. Survival of patients with amputation (n = 30) was not significantly different from patients with limb‐salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells >10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008). Conclusions Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb‐salvage surgery and chemotherapy have an excellent survival. Pediatr Blood Cancer 2011; 57: 415–422. © 2011 Wiley‐Liss, Inc.
doi_str_mv 10.1002/pbc.23172
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A large group of osteosarcoma patients were analyzed at our national oncology center. Procedure To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.8 ± 3.6 years) treated at the Second Department of Pediatrics in Budapest between 1988 and 2006. Demographic parameters, tumor‐related and treatment‐related variables, response, overall survival (OS) and event‐free survival (EFS) were analyzed. Results The 5‐year OS was 68% and 5‐year EFS was 62%. OS of patients without metastasis was 79%, while OS with early metastasis was 17%. Survival of patients with amputation (n = 30) was not significantly different from patients with limb‐salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells &gt;10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008). Conclusions Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb‐salvage surgery and chemotherapy have an excellent survival. 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Blood Cancer</addtitle><description>Background The objective of this report was to estimate long‐term outcome and prognostic factors in children and adolescents with osteosarcoma. A large group of osteosarcoma patients were analyzed at our national oncology center. Procedure To evaluate the efficacy of surgery and multiagent chemotherapy for treating osteosarcoma, we reviewed 122 cases (65 male, 57 female, mean age 13.8 ± 3.6 years) treated at the Second Department of Pediatrics in Budapest between 1988 and 2006. Demographic parameters, tumor‐related and treatment‐related variables, response, overall survival (OS) and event‐free survival (EFS) were analyzed. Results The 5‐year OS was 68% and 5‐year EFS was 62%. OS of patients without metastasis was 79%, while OS with early metastasis was 17%. Survival of patients with amputation (n = 30) was not significantly different from patients with limb‐salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells &gt;10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008). Conclusions Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb‐salvage surgery and chemotherapy have an excellent survival. 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Survival of patients with amputation (n = 30) was not significantly different from patients with limb‐salvage surgery (n = 82), but all patients without radical surgery died. Gender and histological classification had no prognostic significance. Patients with localized tumors in extremities had increased survival compared to patients with axial skeleton tumors (P = 0.013). Poor histological response to neoadjuvant chemotherapy (rate of survivor tumor cells &gt;10%) was associated with decreased survival (P = 0.018). Patients under 14 years had better EFS than patients over 14 years (P = 0.008). Conclusions Our results demonstrate that younger patients with localized osteosarcoma of the extremities who receive limb‐salvage surgery and chemotherapy have an excellent survival. 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subjects Adolescent
Age Factors
Amputation - mortality
Antineoplastic Agents - therapeutic use
chemotherapy
Child
Female
Humans
Limb Salvage - mortality
Male
Neoplasm Metastasis
osteosarcoma
Osteosarcoma - mortality
Osteosarcoma - therapy
outcome research
pediatric oncology
Prognosis
Retrospective Studies
Risk Factors
Survival Analysis
title Good prognosis of localized osteosarcoma in young patients treated with limb-salvage surgery and chemotherapy
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