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Cited by 253Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsOvarian cancer diagnosis and treatment

Neoadjuvant chemotherapy for high‐grade central osteosarcoma of the extremity: Histologic response to preoperative chemotherapy correlates with histologic subtype of the tumor

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Bacci, Gaetano, Bertoni, Franco, Longhi, Alessandra, Ferrari, Stefano, Forni, Cristiana, Biagini, Roberto, Bacchini, Patrizia, Donati, Davide +3 more·2003·Cancer
DOI 10.1002/cncr.11456
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Abstract

BACKGROUND: In primary central high‐grade osteosarcoma, a number of distinct subtypes have been identified, but little is known about the response to chemotherapy. METHODS: The authors investigated whether the subtypes correlated with histologic response to chemotherapy in 1058 patients with osteosarcoma of the extremities who were treated with neoadjuvant chemotherapy over the last 20 years. The tumors were classified as osteoblastic (70%), chondroblastic (13%), fibroblastic (9%), and telangiectatic (6%). At diagnosis, 911 patients had localized disease and 147 had resectable lung metastases. RESULTS: The response to preoperative chemotherapy was good (90% or more tumor necrosis) in 59% of patients and poor (< 90% tumor necrosis) in 41% of patients. The rate of good responses was significantly higher (P = 0.0001) in the fibroblastic (83%) and telangiectatic (80%) tumors and significantly lower in chondroblastic tumors (43%). Prognosis was significantly correlated with the histologic subtypes. The 5‐year overall survival rate was significantly higher (P = 0.0001) in fibroblastic (83%) and telangiectatic (75%) tumors than in osteoblastic (62%) and chondroblastic (60%) tumors. In all subtypes, except for the chondroblastic subtype, the 5‐year overall survival rate was significantly higher (P = 0.0001) in good responders P = 0.0001 (68%) than in poor responders (52%). CONCLUSIONS: The authors concluded that the histologic subtype of primary central high‐grade osteosarcoma of the extremity was strictly correlated with histologic response to chemotherapy and probably, as a consequence, also with prognosis. Further studies are needed to establish whether these results justify a specific therapeutic approach based on the histologic subtype of the tumor. Cancer 2003;97:3068–75. © 2003 American Cancer Society. DOI 10.1002/cncr.11456

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  • Some studies suggested that chondroblastic and telangiectatic histological subtypes have less necrosis, but those differences have not translated into improved survival.

    “Some studies suggested that the histological subtype of osteosarcoma can influence the degree of necrosis, with chondroblastic and telangiectatic subtypes having less necrosis but those differences have not translated into improvement in survival 1,118 .”

    From Osteosarcoma (2022) · cites this paper as [118]

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Research works printed but not linked: 5

  1. Dorfman DH, Czerniak B. Bone tumors. St. Louis: Mosby, 1997.
  2. Bacci G, Picci P, Ferrari S, et al. Primary chemotherapy and delayed surgery for nonmetastatic osteosarcoma of the ex- tremities. Results in 164 patients preoperatively treated with high doses of methotrexate followed by cisplatin and doxo- rubicin. Cancer. 1993;72:3227-3238.
  3. Bentzen SM, Poulsen HS, Kaae S, et al. Prognostic factors in osteosarcomas. A regression analysis. Cancer. 1988;62:194 - 202.
  4. Bacci G, Picci P, Ferrari S, et al. Prognostic significance of serum alkaline phosphatase measurements in patients with osteosarcoma treated with adjuvant or neoadjuvant chemo- therapy. Cancer. 1993;71:1224 -1230.
  5. Picci P, Bacci G, Campanacci M, et al. Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy. Re- gional mapping of viable and nonviable tumor. Cancer. 1985;56:1515-1521.

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Authors
Bacci, G., Bertoni, F., Longhi, A., Ferrari, S., Forni, C., Biagini, R., Bacchini, P., Donati, D., Manfrini, M., Bernini, G., & Lari, S.
Affiliations
  • Istituto Ortopedico Rizzoli (IT)
  • Meyer Children's Hospital (IT)
Corresponding author
Bacci, Gaetano
ORCID
Venue
Cancer
Publisher
Wiley
Published
2003-05-29
Volume
97
Issue
12
Pages
3068-3075
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
DOI
10.1002/cncr.11456
OpenAlex
W1975088474
Cited by
253
References
31
Citations by year
2026: 6 · 2025: 18 · 2024: 19 · 2023: 15 · 2022: 10 · 2021: 22 · 2020: 15 · 2019: 6 · 2018: 8 · 2017: 11 · 2016: 14 · 2015: 14 · 2014: 16 · 2013: 14 · 2012: 11
FWCI
4.32
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
Keywords
high-grade osteosarcoma, extremity osteosarcoma, neoadjuvant chemotherapy, histological subtypes, tumor necrosis, chemotherapy response, overall survival, prognosis
MeSH terms
Adolescent, Extremities, Female, Humans, Male, Preoperative Care, Prognosis, Osteosarcoma, Survival Analysis, Chemotherapy, Adjuvant, Neoadjuvant Therapy, Antineoplastic Protocols

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