A population-based analysis of the presentation and outcomes of pediatric patients with osteosarcoma in Canada: a report from CYP-C

Background: Frequently occurring in adolescents, osteosarcoma is the most common primary malignant bone disease, with a reported 15% of patients who present with metastasis. With advances in imaging and improvements in surgical care, an updated analysis is warranted on the outcomes of pediatric patients with osteosarcoma. Methods: We completed a retrospective review of pediatric patients who presented with osteosarcoma between 2001 and 2017, using The Cancer in Young People in Canada (CYP-C) national database. Data on 304 patients aged younger than 15 years were analyzed. Results: The proportion of patients who presented with metastasis was 23.0%. The overall 5-year survival (OS) for patients who presented with metastasis was 37.4%. Overall survival and event-free survival (EFS) were lower in these patients than in patients with localized disease (hazard ratio [HR] 4.3, p < 0.0001 and HR 3.1, p < 0.0001). For patients who presented with metastatic disease, the OS for those undergoing an operative intervention was 44.1% compared with 17.6% for those who did not undergo resection (p < 0.0001). Conclusion: The proportion of patients who presented with metastatic osteosarcoma in our population is higher than previously reported. Overall outcomes of patients with metastatic disease have not changed. Our data reaffirm a role for surgical resection in patients with metastasis with a need to explore new treatment strategies to improve the overall prognosis of these patients. Contexte : L'osteosarcome, un cancer qui touche souvent les adolescents, est l'atteinte osseuse primitive maligne la plus frequente; on rapporte que 15 % des patients presenteront des metastases. Considerant les avancees realisees en imagerie et les ameliorations apportees aux soins chirurgicaux, il est temps de mettre a jour l'analyse des resultats des patients pediatriques atteints d'osteosarcome. Methodes : A partir de la base de donnees nationale du programme Cancer chez les jeunes au Canada (CCJC), nous avons realise une etude retrospective des patients pediatriques ayant recu un diagnostic d'osteosarcome entre 2001 et 2017. Nous avons analyse des donnees provenant de 304 patients ages de moins de 15 ans. Resultats : La proportion de patients ayant presente des metastases etait de 23,0 %, et leur taux de survie globale a 5 ans etait de 37,4 %. Les taux de survie globale et de survie sans evenement de ces patients etaient inferieurs aux taux observes chez les patients atteints d'une maladi