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Cited by 147Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsAcute Lymphoblastic Leukemia research

Pattern of disease recurrence and prognostic factors in patients with osteosarcoma treated with contemporary chemotherapy

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Hawkins, Douglas S., Arndt, Carola A. S.·2003·Cancer
DOI 10.1002/cncr.11799
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Abstract

BACKGROUND: The goal of the current study was to define the clinical features and outcome of recurrent osteosarcoma (OS) in children and young adults initially treated with contemporary chemotherapy. METHODS: The authors reviewed the clinical features, therapy, and outcome for 59 patients from the Mayo Clinic (Rochester, MN) and Children's Hospital and Regional Medical Center (Seattle, WA). They were diagnosed initially with OS between January 1990 and December 2000, received multiagent chemotherapy (most frequently cisplatin, doxorubicin, high‐dose methotrexate, and ifosfamide), and developed disease recurrence after achieving an initial complete response (CR). RESULTS: The most common site of initial disease recurrence was the lung only (n = 36 patients), followed by distant bone (n =8 patients), combined lung and other sites (n =7 patients), and other sites (n =8 patients). The median time to first disease recurrence was 15 months (range, 2–92 months) from the initial diagnosis. Thirty patients with isolated pulmonary recurrence achieved a second CR, either with surgery alone (n =15 patients) or surgery and salvage chemotherapy (n =15 patients). For this group, the 4‐year disease‐free survival (DFS) and overall survival rates were 7% (95% confidence interval [95% CI], 0–16%) and 28% (95% CI, 11–45%), respectively. For all 59 patients with recurrent OS, the 4‐year DFS and overall survival rates were 6% (95% CI, 0–12%) and 23% (95% CI, 10–36%), respectively. The only factors associated with improved DFS and overall survival rates were unilateral pulmonary recurrence, solitary pulmonary nodule at recurrence, more than 24 months between the initial diagnosis and first disease recurrence, and achievement of a second CR. CONCLUSIONS: The DFS and overall survival rates for recurrent OS after contemporary therapy remained poor even for patients with isolated pulmonary recurrence. Therefore, new treatment strategies are needed. Cancer 2003. © 2003 American Cancer Society.

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  • A shorter relapse-free interval and older age are prognostic for shorter overall survival in patients with osteosarcoma.

    “These strata were based on studies showing that a shorter relapse-free interval and older age are prognostic for shorter OS in patients with osteosarcoma.”

    From Lenvatinib Plus Ifosfamide and Etoposide in Children and Young Adults With Relapsed Osteosarcoma (2024) · cites this paper as [32]

    Table 4 reports lower four-year overall survival for patients whose relapse-free interval was 24 months or less than for those with a longer interval (17% versus 38%). The paper reports patients’ ages in Table 1 but does not identify older age as a prognostic factor for overall survival. Page numbers are not available in our copy. (LLM, conf=0.88)

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  • Surgical resection was associated with prolonged survival.

    “These results suggest that surgical resection was associated with prolonged survival, consistent with published data.”

    From Lenvatinib Plus Ifosfamide and Etoposide in Children and Young Adults With Relapsed Osteosarcoma (2024) · cites this paper as [32]

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References 41 · Cited by 147

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  1. Link MP, Goorin AM, Miser AW, et al. The effect of adjuvant chemotherapy on relapse-free survival in patients with os- teosarcoma of the extremity. N Engl J Med. 1986;314:1600 - 1606.
  2. Meyers PA, Gorlick R. Osteosarcoma. Pediatr Clin North Am. 1997;44:973-989.
  3. Martini N, Huvos AG, Mike V, Marcove RC, Beattie EJ Jr. Multiple pulmonary resections in the treatment of osteo- genic sarcoma. Ann Thorac Surg. 1971;12:271-280.
  4. Spanos PK, Payne WS, Ivins JC, Pritchard DJ. Pulmonary resection for metastatic osteogenic sarcoma. J Bone Joint Surg [A]. 1976;58:624 -628.
  5. Telander RL, Pairolero PC, Pritchard DJ, Sim FH, Gilchrist GS. Resection of pulmonary metastatic osteogenic sarcoma in children. Surgery. 1978;84:335-341.
  6. Rosenberg SA, Flye MW, Conkle D, Seipp CA, Levine AS, Simon RM. Treatment of osteogenic sarcoma. II. Aggressive resection of pulmonary metastases. Cancer Treat Rep. 1979; 63:753-756.
  7. Schaller RT, Haas J, Schaller J, Morgan A, Bleyer A. Improved survival in children with osteosarcoma following resection of pulmonary metastases. J Pediatr Surg. 1982;17:546 -550.
  8. Putnam JB, Roth JA, Wesley MN, Johnston MR, Rosenberg SA. Survival following aggressive resection of pulmonary metastases from osteogenic sarcoma: analysis of prognostic factors. Ann Thorac Surg. 1983;36:516 -523.
  9. Goorin AM, Delorey MJ, Lack EE, et al. Prognostic signifi- cance of complete surgical resection of pulmonary metas- tases in patients with osteogenic sarcoma: analysis of 32 patients. J Clin Oncol. 1984;2:425-431.
  10. Carter SR, Grimer RJ, Sneath RS, Matthews HR. Results of thoracotomy in osteogenic sarcoma with pulmonary metas- tases. Thorax. 1991;46:727-731.
  11. Goorin AM, Shuster JJ, Baker A, Horowitz ME, Meyer WH, Link MP. Changing pattern of pulmonary metastases with adjuvant chemotherapy in patients with osteosarcoma: re- sults from the Multiinstitutional Osteosarcoma Study. J Clin Oncol. 1991;9:600 -605.
  12. Pastorino U, Gasparini M, Tavecchio L, et al. The contribu- tion of salvage surgery to the management of childhood osteosarcoma. J Clin Oncol. 1991;9:1357-1362.
  13. La Quaglia MP. The surgical management of metastases in pediatric cancer. Semin Pediatr Surg. 1993;2:75-82.
  14. Tabone M-D, Kalifa C, Rodary C, Raquin M, Valteau-Coura- net D, Lemerle J. Osteosarcoma recurrences in pediatric patients previously treated with intensive chemotherapy. J Clin Oncol. 1994;12:2614 -2620.
  15. Ward WG, Mikaelian K, Dorey F, et al. Pulmonary metasta- ses of stage IIB extremity osteosarcoma and subsequent pulmonary metastases. J Clin Oncol. 1994;12:1849 -1858.
  16. Heij HA, Vos A, de Kraker J, Vou ˆte PA. Prognostic factors in surgery for pulmonary metastases in children. Surgery. 1994; 115:687-693.
  17. Temeck BK, Wexler LH, Steinberg SM, McClure LL, Horo- witz M, Pass HI. Metastasectomy for sarcomatous pediatric histologies: results and prognostic factors. Ann Thorac Surg. 1995;59:1385-1390.
  18. Saeter G, Høie J, Stenwig AE, Johannsson AK, Hannisdal E, Solheim Ø. Systemic relapse of patients with osteogenic sarcoma: prognostic factors in long term survival. Cancer. 1995;75:1084 -1093.
  19. Ferrari S, Bacci G, Picci P, et al. Long-term follow-up and post-relapse survival in patients with non-metastatic osteo- sarcoma of the extremity treated with neoadjuvant chemo- therapy. Ann Oncol. 1997;8:765-771.
  20. Ellis PM, Tattersall MHN, McCaughan B, Stalley P. Osteo- sarcoma and pulmonary metastases: 15-year experience from a single institution. Aust N Z J Surg. 1997;67:625-629.
  21. Bacci G, Ferrari S, Longhi A, et al. Pattern of relapse in patients with osteosarcoma of the extremities treated with neoadjuvant chemotherapy. Eur J Cancer. 2001;37:32-38.
  22. Weeden S, Grimmer RJ, Cannon SR, Taminiau AH, Uscinska BM. The effect of local recurrence on survival of resected osteosarcoma. Eur J Cancer. 2001;37:39 -46.
  23. McCarville MB, Kaste SC, Cain AM, Goloubeva O, Rao BN, Pratt CB. Prognostic factors and imaging patterns of recur- rent pulmonary nodules after thoracotomy in children with osteosarcoma. Cancer. 2001;91:1170 -1176.
  24. Tsuchiya H, Kanazawa Y, Abdel-Wanis ME, et al. Effect of timing of pulmonary metastases identification on prognosis of patients with osteosarcoma: the Japanese Musculoskele- tal Oncology Group Study. J Clin Oncol. 2002;20:3470 -3477.
  25. Ferrari S, Briccoli A, Mercuri M, et al. Post-relapse survival in osteosarcoma of the extremities: prognostic factors for long- term survival. J Clin Oncol. 2003;21:710 -715.
  26. Miser J, Arndt C, Smithson W, et al. Treatment of high-grade osteosarcoma (OGS) with ifosfamide (IFOS), MESNA (MES), Adriamycin (ADR), high-dose methotrexate (HDMTX), with or without cisplatin (CDDP); results of two pilot trials [ab- stract]. Proc Am Soc Clin Oncol. 1994;13:421a.
  27. Arndt C, Miser J, Prichard D, et al. Treatment of high-grade osteosarcoma (OGS) with ifosfamide (IFOS), MESNA (MES), Adriamycin (ADR), high-dose methotrexate (HDMTX), and cisplatin (CDDP) [abstract]. Med Pediatr Oncol. 1996;27: 227a.
  28. Meyers P, Schwartz C, Bernstein M, et al. Addition of ifosf- amide and muramyl tripeptide to cisplatin, doxorubicin, and high-dose methotrexate improves event free survival (EFS) in localized osteosarcoma (OS) [abstract]. Proc Am Soc Clin Oncol. 2001;20:367a.
  29. Seibel N, Krailo M, Sato J, et al. Phase II window of topote- can in newly diagnosed metastatic osteosarcoma-CCG 7943 [abstract]. Proc Am Soc Clin Oncol. 2001;20:378a.
  30. Nachman J, Simon M, Rubin C, Peabody T. Intensive pre- operative therapy with escalating doses of ifosfamide and carboplatin in conjunction with Adriamycin for patients with localized osteosarcoma [abstract]. Med Pediatr Oncol. 2001;37:176a.
  31. Womer RB, Daller RT, Fenton JG, Miser JS. Granulocyte colony stimulating factor permits dose intensification by interval compression in the treatment of Ewing's sarcomas and soft tissue sarcomas in children. Eur J Cancer. 2000;36: 87-94.
  32. Miser JS, Kinsella TJ, Triche TJ, et al. Ifosfamide with mesna uroprotection and etoposide: an effective regimen in the treatment of recurrent sarcomas and other tumors of chil- dren and young adults. J Clin Oncol. 1987;5:1191-1198.
  33. Cairo MS, Shen V, Krailo MD, et al. Prospective randomized trial between two doses of granulocyte colony-stimulating factor after ifosfamide, carboplatin, and etoposide in chil- dren with recurrent or refractory solid tumors: a Children's Cancer Group report. J Pediatr Hematol Oncol. 2001;23:30 - 38.
  34. Kaplan EL, Meier P. Nonparametric estimation from incom- plete observations. J Am Stat Assoc. 1958;53:457-481.
  35. Peto R, Pike MC, Armitage P, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient: I-analysis and examples. Br J Cancer. 1977; 35:1-39.
  36. Anderson PM, Wiseman GA, Dispenzieri A, et al. High-dose samarium-153 ethylene diamine tetramethylene phospho- nate: low toxicity of skeletal irradiation in patients with osteosarcoma and bone metastases. J Clin Oncol. 2002;20: 189 -196.
  37. Franzius C, Bielack S, Sciuk J, Vollet B, Ju ¨rgens H, Schober O. High activity samarium-152 EDTMP therapy in unresectable osteosarcoma. Nuklearmedizin. 1999;38:337-340.
  38. Welsh JS, Thurman SA, Borzillary S, Schwartz CL, Howard SP. Sm-153 EDTMP for recurrent metastatic osteosarcoma. Clin Adv Hematol Oncol. 2003;1:181-183.
  39. Kleinerman ES. Biologic therapy for osteosarcoma using liposome-encapsulated muramyl tripeptide. Hematol Oncol Clin North Am. 1995;9:927-938.
  40. Anderson PM, Markovic SN, Sloan JA, et al. Aerosol granu- locyte macrophage-colony stimulating factor: a low toxicity, lung-specific biological therapy in patients with lung metas- tases. Clin Cancer Res. 1999;5:2316 -2323.

Authors
Hawkins, D. S., & Arndt, C. A. S.
Affiliations
  • Seattle Children's Hospital (US)
  • Mayo Clinic (US)
Corresponding author
Hawkins, Douglas S.
ORCID
Hawkins, Douglas S.
Venue
Cancer
Publisher
Wiley
Published
2003-11-17
Volume
98
Issue
11
Pages
2447-2456
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
DOI
10.1002/cncr.11799
OpenAlex
W2041936982
Cited by
147
References
41
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 1 · 2018: 5 · 2017: 4 · 2016: 12 · 2015: 14 · 2014: 6 · 2013: 7 · 2012: 8
FWCI
4.80
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
Keywords
osteosarcoma, recurrence, pulmonary recurrence, prognostic factors, combination chemotherapy, cisplatin, doxorubicin, high-dose methotrexate, ifosfamide, salvage chemotherapy, disease-free survival, overall survival, children and young adults
MeSH terms
Adolescent, Adult, Antineoplastic Combined Chemotherapy Protocols, Bone Neoplasms, Child, Child, Preschool, Female, Humans, Lung Neoplasms, Male, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies, Osteosarcoma, Treatment Outcome, Disease-Free Survival

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