Cited by 2,393Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsOvarian cancer diagnosis and treatment

The DOI matches its Crossref record; 61 of the 61 references it cites were found in a registry or an index.

Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols

Bielack, Stefan S., Kempf-Bielack, Beate, Delling, Günter, Exner, G. Ulrich, Flege, Silke, Helmke, Knut, Kotz, Rainer, Salzer-Kuntschik, Mechthild, Werner, Matthias, Winkelmann, Winfried, Zoubek, Andreas, Jürgens, Heribert, Winkler, Kurt·2002·Journal of Clinical Oncology

DOI 10.1200/jco.2002.20.3.776

Open this paper in CoChat — free account

Abstract

PURPOSE: To define prognostic factors for response and long-term outcome for a wide spectrum of osteosarcomas, extending well beyond those of the typical young patient with seemingly localized extremity disease. PATIENTS AND METHODS: A total of 1,702 consecutive newly diagnosed patients with high-grade osteosarcoma of the trunk or limbs registered into the neoadjuvant studies of the Cooperative Osteosarcoma Study Group before July 1998 were entered into an analysis of demographic, tumor-related, and treatment-related variables, response, and survival. The intended therapeutic strategy included preoperative and postoperative chemotherapy with multiple agents as well as surgery of all operable lesions. RESULTS: Axial tumor site, male sex, and a long history of symptoms were associated with poor response to chemotherapy in univariate and multivariate analysis. Actuarial 10-year overall and event-free survival rates were 59.8% and 48.9%. Among the variables assessable at diagnosis, patient age (actuarial 10-year survival ≥ 40, 41.6%; < 40, 60.2%; P = .012), tumor site (axial, 29.2%; limb, 61.7%; P < .0001), and primary metastases (yes, 26.7%; no, 64.4%; P < .0001), and for extremity osteosarcomas, also size (≥ one third, 52.5%; < one third, 66.7%; P < .0001) and location within the limb (proximal, 49.3%; other, 63.9%; P < .0001), had significant influence on outcome. Two additional important prognostic factors were treatment related: response to chemotherapy (poor, 47.2%; good, 73.4%; P < .0001) and the extent of surgery (incomplete, 14.6%; macroscopically complete, 64.8%; P < .0001). All factors except age maintained their significance in multivariate testing, with surgical remission and histologic response emerging as the key prognostic factors. CONCLUSION: Tumor site and size, primary metastases, response to chemotherapy, and surgical remission are of independent prognostic value in osteosarcoma.

Integrity signals

Registry

Crossref · 10.1200/jco.2002.20.3.776

Cites

61 of 61 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1992) · Springer series in statistics · doi:10.1007/978-1-4612-4380-9_25 · Cited by 45,239
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Nonparametric Estimation from Incomplete Observations
Kaplan, E. L., & Meier, P. (1958) · Journal of the American Statistical Association · doi:10.1080/01621459.1958.10501452 · Cited by 39,158
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297
Evaluation of survival data and two new rank order statistics arising in its consideration.
Mantel, N. (1966) · PubMed · Cited by 7,516
The Analysis of Binary Data.
Plackett, R. L., & Cox, D. R. (1971) · Journal of the Royal Statistical Society Series A (General) · doi:10.2307/2344247 · Cited by 2,274
Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials
Hutchins, L. F., Unger, J. M., Crowley, J. J., Coltman, C. A., & Albain, K. S. (1999) · New England Journal of Medicine · doi:10.1056/nejm199912303412706 · Cited by 2,171
The Effect of Adjuvant Chemotherapy on Relapse-Free Survival in Patients with Osteosarcoma of the Extremity
Link, M. P., Goorin, A. M., Miser, A. W., Green, A. A., Pratt, C. B., Belasco, J. B., Pritchard, J., Malpas, J. S., Baker, A. R., Kirkpatrick, J. A., et al. (1986) · New England Journal of Medicine · doi:10.1056/nejm198606193142502 · Cited by 1,203
Preoperative chemotherapy for osteogenic sarcoma:Selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy
Rosen, G., Caparros, B., Huvos, A. G., Kosloff, C., Nirenberg, A., Cacavio, A., Marcove, R. C., Lane, J. M., Mehta, B. M., & Urban, C. (1982) · Cancer · doi:10.1002/1097-0142(19820315)49:6 · Cited by 1,082
Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience.
Meyers, P. A., Heller, G., Healey, J. H., Huvos, A. G., Lane, J. M., Marcove, R. C., Applewhite, A., Vlamis, V., & Rosen, G. (1992) · Journal of Clinical Oncology · doi:10.1200/jco.1992.10.1.5 · Cited by 675

Show all 61 references

Sorted by citations

Osteosarcoma: Current Treatment and a Collaborative Pathway to Success
Isakoff, M. S., Bielack, S., Meltzer, P. S., & Gorlick, R. G. (2015) · Journal of Clinical Oncology · doi:10.1200/jco.2014.59.4895 · Cited by 1,578
“most commonly occurs in the distal femur (43%), proximal tibia (23%), or humerus (10%).(1) The typ-”
BackgroundSelf-citation
Osteosarcoma treatment – Where do we stand? A state of the art review
Lütke, A., Meyers, P. A., Lewis, I. J., & Juergens, H. (2013) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2013.11.006 · Cited by 1,237
Osteosarcoma
Ritter, J., & Bielack, S. (2010) · Annals of Oncology · doi:10.1093/annonc/mdq276 · Cited by 1,050
“The most common primary sites are the distal femur, the proximal tibia, and the proximal humerus, with 50% originating around the knee [3, 7, 8].”
BackgroundSelf-citation
Primary Metastatic Osteosarcoma: Presentation and Outcome of Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols
Kager, L., Zoubek, A., Pötschger, U., Kastner, U., Flege, S., Kempf-Bielack, B., Branscheid, D., Kotz, R., Salzer-Kuntschik, M., Winkelmann, W., et al. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.08.132 · Cited by 934
Self-citation
Advancing therapy for osteosarcoma
Gill, J., & Gorlick, R. (2021) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-021-00519-8 · Cited by 876
Recurrent Somatic Structural Variations Contribute to Tumorigenesis in Pediatric Osteosarcoma
Chen, X., Bahrami, A., Pappo, A., Easton, J., Dalton, J., Hedlund, E., Ellison, D., Shurtleff, S., Wu, G., Wei, L., et al. (2014) · Cell Reports · doi:10.1016/j.celrep.2014.03.003 · Cited by 752
Survival and prognosis with osteosarcoma: outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort
Smeland, S., Bielack, S. S., Whelan, J., Bernstein, M., Hogendoorn, P., Krailo, M. D., Gorlick, R., Janeway, K. A., Ingleby, F. C., Anninga, J., et al. (2019) · European Journal of Cancer · doi:10.1016/j.ejca.2018.11.027 · Cited by 704
Self-citation
Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Hogendoorn, P. C. W., Athanasou, N. A., Bielack, S., de Álava, E., Tos, A. P. D., Ferrari, S., Gelderblom, H. A. J., Grimer, R. J., Hall, K. S., Hassan, A. B., et al. (2010) · Annals of Oncology · doi:10.1093/annonc/mdq223 · Cited by 716
Self-citation
Current and future therapeutic approaches for osteosarcoma
Harrison, D. J., Geller, D. S., Gill, J. B., Lewis, V. O., & Gorlick, R. G. (2017) · Expert Review of Anticancer Therapy · doi:10.1080/14737140.2018.1413939 · Cited by 691
Osteosarcoma
Beird, H. C., Bielack, S. S., Flanagan, A. M., Gill, J., Heymann, D., Janeway, K. A., Livingston, J. A., Roberts, R. D., Strauss, S. J., & Gorlick, R. (2022) · Nature Reviews Disease Primers · doi:10.1038/s41572-022-00409-y · Cited by 660
Self-citation
Biology and Therapeutic Advances for Pediatric Osteosarcoma
Marina, N. M., Gebhardt, M. C., Teot, L. A., & Gorlick, R. G. (2004) · The Oncologist · doi:10.1634/theoncologist.9-4-422 · Cited by 670
Bone sarcomas: ESMO-PaedCan-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up.
Casali, P. G., Bielack, S., Abecassis, N., Aro, H. T., Bauer, S., Biagini, R., Bonvalot, S., Boukovinas, I., Bovee, J. V. M. G., Brennan, B., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy310 · Cited by 617
Self-citation
Osteosarcoma Relapse After Combined Modality Therapy: An Analysis of Unselected Patients in the Cooperative Osteosarcoma Study Group (COSS)
Kempf-Bielack, B., Bielack, S. S., Jürgens, H., Branscheid, D., Berdel, W. E., Exner, G. U., Göbel, U., Helmke, K., Jundt, G., Kabisch, H., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.04.063 · Cited by 643
Self-citation
New Horizons in the Treatment of Osteosarcoma
Meltzer, P. S., & Helman, L. J. (2021) · New England Journal of Medicine · doi:10.1056/nejmra2103423 · Cited by 672
Primary bone osteosarcoma in the pediatric age: State of the art
Longhi, A., Errani, C., PAOLIS, M. D., Mercuri, M., & Bacci, G. (2006) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2006.05.005 · Cited by 630
Comparison of MAPIE versus MAP in patients with a poor response to preoperative chemotherapy for newly diagnosed high-grade osteosarcoma (EURAMOS-1): an open-label, international, randomised controlled trial
Marina, N. M., Smeland, S., Bielack, S. S., Bernstein, M., Jovic, G., Krailo, M. D., Hook, J. M., Arndt, C., van den Berg, H., Brennan, B., et al. (2016) · The Lancet Oncology · doi:10.1016/s1470-2045(16)30214-5 · Cited by 551
Self-citation
Osteosarcoma: a comprehensive review
Misaghi, A., Goldin, A. N., Awad, M. A. H., & Kulidjian, A. (2018) · SICOT-J · doi:10.1051/sicotj/2017028 · Cited by 550
Osteosarcoma Overview
Lindsey, B. A., Markel, J., & Kleinerman, E. S. (2016) · Rheumatology and Therapy · doi:10.1007/s40744-016-0050-2 · Cited by 490
Osteosarcoma, Chondrosarcoma, and Chordoma
Whelan, J., & Davis, L. E. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2017.75.1743 · Cited by 477
Germline and somatic genetics of osteosarcoma — connecting aetiology, biology and therapy
Gianferante, D. M., Mirabello, L. J., & Savage, S. A. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.16 · Cited by 477
Chemotherapeutic adjuvant treatment for osteosarcoma: Where do we stand?
Anninga, J. K., Gelderblom, H., Fiocco, M., Kroep, J. R., Taminiau, A. H. M., Hogendoorn, P. C. W., & Egeler, R. M. (2011) · European Journal of Cancer · doi:10.1016/j.ejca.2011.05.030 · Cited by 456
Tumor-Infiltrating Macrophages Are Associated with Metastasis Suppression in High-Grade Osteosarcoma: A Rationale for Treatment with Macrophage Activating Agents
Buddingh, E. P., Kuijjer, M. L., Duim, R. A. J., Bürger, H., Agelopoulos, K., Myklebost, O., Serra, M., Mertens, F., Hogendoorn, P. C. W., Lankester, A. C., et al. (2011) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-10-2047 · Cited by 508
Methotrexate, Doxorubicin, and Cisplatin (MAP) Plus Maintenance Pegylated Interferon Alfa-2b Versus MAP Alone in Patients With Resectable High-Grade Osteosarcoma and Good Histologic Response to Preoperative MAP: First Results of the EURAMOS-1 Good Response Randomized Controlled Trial
Bielack, S. S., Smeland, S., Whelan, J. S., Marina, N., Jovic, G., Hook, J. M., Krailo, M. D., Gebhardt, M., Pápai, Z., Meyer, J., et al. (2015) · Journal of Clinical Oncology · doi:10.1200/jco.2014.60.0734 · Cited by 422
“The observed 3-year EFS of 76% for the 716 randomly assigned patients meeting our eligibility criteria is in the range of those previously observed for good responders.(4,9,12,28) Approximately four fifths of first events were exclusively metastatic, and there was no suggestion of an altered distribution of type of ev…”
BackgroundSelf-citation
Positron Emission Tomography for Staging of Pediatric Sarcoma Patients: Results of a Prospective Multicenter Trial
Völker, T., Denecke, T., Steffen, I. G., Misch, D., Schönberger, S., Plotkin, M., Ruf, J., Furth, C., Stöver, B., Hautzel, H., et al. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2007.12.2473 · Cited by 395
Review of Osteosarcoma and Current Management
Durfee, R. A., Mohammed, M., & Luu, H. H. (2016) · Rheumatology and Therapy · doi:10.1007/s40744-016-0046-y · Cited by 409
“Other poor predictors of survival are increased tumor size, increased serum alkaline phosphatase, axial location, and secondary OS [102].”
Background
Presurgical Chemotherapy Compared With Immediate Surgery and Adjuvant Chemotherapy for Nonmetastatic Osteosarcoma: Pediatric Oncology Group Study POG-8651
Goorin, A. M., Schwartzentruber, D. J., Devidas, M., Gebhardt, M. C., Ayala, A. G., Harris, M. B., Helman, L. J., Grier, H. E., & Link, M. P. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.08.165 · Cited by 394
A phase II trial of sorafenib in relapsed and unresectable high-grade osteosarcoma after failure of standard multimodal therapy: an Italian Sarcoma Group study
Grignani, G., Palmerini, E., Dileo, P., Asaftei, S. D., D’Ambrosio, L., Pignochino, Y., Mercuri, M., Picci, P., Fagioli, F., Casali, P. G., et al. (2012) · Annals of Oncology · doi:10.1093/annonc/mdr151 · Cited by 359
Exome sequencing of osteosarcoma reveals mutation signatures reminiscent of BRCA deficiency
Kovac, M., Blattmann, C., Ribi, S., Smida, J., Mueller, N. S., Engert, F., Castro-Giner, F., Weischenfeldt, J., Kovacova, M., Krieg, A., et al. (2015) · Nature Communications · doi:10.1038/ncomms9940 · Cited by 353
Self-citation
Osteosarcoma
Moore, D. D., & Luu, H. H. (2014) · Cancer treatment and research · doi:10.1007/978-3-319-07323-1_4 · Cited by 350
The Molecular Pathogenesis of Osteosarcoma: A Review
Broadhead, M. L., Clark, J. C. M., Myers, D. E., Dass, C. R., & Choong, P. (2011) · Sarcoma · doi:10.1155/2011/959248 · Cited by 355
“Despite modern treatment protocols that combine chemotherapy, surgery, and sometimes radiotherapy, the 5year survival rate for patients diagnosed with osteosarcoma remains at 60%–70% [1].”
Background
Improvement in Histologic Response But Not Survival in Osteosarcoma Patients Treated With Intensified Chemotherapy: A Randomized Phase III Trial of the European Osteosarcoma Intergroup
Lewis, I. J., Nooij, M. A., Whelan, J. S., Sydes, M. R., Grimer, R. J., Hogendoorn, P. C. W., Memon, M. A., Weeden, S., Uscinska, B., Glabbeke, M. M. V., et al. (2007) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djk015 · Cited by 344
Osteosarcoma of the Pelvis: Experience of the Cooperative Osteosarcoma Study Group
Ozaki, T., Flege, S., Kevric, M., Lindner, N. J., Maas, R., Delling, G., Schwarz, R., Hochstetter, A. R. V., Salzer-Kuntschik, M., Berdel, W. E., et al. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.01.142 · Cited by 342
Self-citation
Use of PET for monitoring cancer therapy and for predicting outcome.
Weber, W. (2005) · PubMed · Cited by 338
Sorafenib and everolimus for patients with unresectable high-grade osteosarcoma progressing after standard treatment: a non-randomised phase 2 clinical trial
Grignani, G., Palmerini, E., Ferraresi, V., D’Ambrosio, L., Bertulli, R., Asaftei, S. D., Tamburini, A., Pignochino, Y., Sangiolo, D., Marchesi, E., et al. (2014) · The Lancet Oncology · doi:10.1016/s1470-2045(14)71136-2 · Cited by 343
Sarcomas of the head and neck region
Sturgis, E. M., & Potter, B. O. (2003) · Current Opinion in Oncology · doi:10.1097/00001622-200305000-00011 · Cited by 324
Osteosarcoma: a review of current and future therapeutic approaches
Zhao, X. B., Wu, Q., Gong, X., Liu, J., & Ma, Y. (2021) · BioMedical Engineering OnLine · doi:10.1186/s12938-021-00860-0 · Cited by 341
Prognostic factors for survival in patients with high-grade osteosarcoma using the Surveillance, Epidemiology, and End Results (SEER) Program database
Duchman, K. R., Gao, Y., & Miller, B. J. (2015) · Cancer Epidemiology · doi:10.1016/j.canep.2015.05.001 · Cited by 303
“As chemotherapeutic regimens intensified, survival for patients with high-grade osteosarcoma improved, with 5-year survival rates for patients with non-metastatic disease reported above 60% [1,2,5,6].”
BackgroundInfluential
Using Epidemiology and Genomics to Understand Osteosarcoma Etiology
Savage, S. A., & Mirabello, L. J. (2011) · Sarcoma · doi:10.1155/2011/548151 · Cited by 309
“Osteosarcoma occurs most frequently in the lower long bones [1, 5, 7, 21] (Figure 3).”
Background
Metastatic osteosarcoma: a challenging multidisciplinary treatment
Meazza, C., & Scanagatta, P. (2016) · Expert Review of Anticancer Therapy · doi:10.1586/14737140.2016.1168697 · Cited by 300
“OS commonly occurs in long bones of the extremities such as the distal femur (42% of cases), the proximal tibia (19%), and the proximal humerus (10%) [7].”
Background
Bone Microenvironment and Osteosarcoma Metastasis
Yang, C., Tian, Y. E., Zhao, F., Chen, Z., Su, P., Li, Y., & Qian, A. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21196985 · Cited by 298
“Tumor metastasis is the primary problem for tumor therapy [23].”
Background
Bone Cancer: Diagnosis and Treatment Principles.
Ferguson, J. L., & Turner, S. P. (2018) · PubMed · Cited by 286
Bone tumours in European children and adolescents, 1978–1997. Report from the Automated Childhood Cancer Information System project
Stiller, C. A., Bielack, S., Jundt, G., & Steliarova‐Foucher, E. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2006.05.015 · Cited by 283
Self-citation
Endoprosthetic replacement of the distal femur for bone tumours
Myers, G. J. C., Abudu, A., Carter, S. R., Tillman, R. M., & Grimer, R. J. (2007) · Journal of Bone and Joint Surgery - British Volume · doi:10.1302/0301-620x.89b4.18631 · Cited by 278
Osteosarcoma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up
Bielack, S., Carrle, D., & Casali, P. G. (2009) · Annals of Oncology · doi:10.1093/annonc/mdp154 · Cited by 272
Self-citation
New targets and approaches in osteosarcoma
Gill, J. B., Ahluwalia, M., Geller, D., & Gorlick, R. G. (2012) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2012.09.003 · Cited by 274
Osteosarcoma originates from mesenchymal stem cells in consequence of aneuploidization and genomic loss of Cdkn2
Mohseny, A. B., Szuhai, K., Romeo, S. O., Buddingh, E. P., Bruijn, I. H. B., de Jong, D., van Pel, M., Cleton-Jansen, A., & Hogendoorn, P. C. W. (2009) · The Journal of Pathology · doi:10.1002/path.2603 · Cited by 270
Osteosarcoma
Messerschmitt, P. J., Garcia, R., Abdul‐Karim, F. W., Greenfield, E. M., & Getty, P. J. (2009) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/00124635-200908000-00005 · Cited by 268
“a multidisciplinary approach is used.(3,4,26,29) For high-grade osteosar-”
BackgroundInfluential
New molecular insights into osteosarcoma targeted therapy
Yang, J., & Zhang, W. (2013) · Current Opinion in Oncology · doi:10.1097/cco.0b013e3283622c1b · Cited by 262
“Despite modern multidisciplinary treatments including chemotherapy and surgery, the 5-year survival rate of osteosarcoma patients remains 60–70% [1,2].”
Background
Bone sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
(2014) · Annals of Oncology · doi:10.1093/annonc/mdu256 · Cited by 264
“The extent of histological response to preoperative chemotherapy predicts survival [21, 23, 24].”
Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: osteosarcoma and related tumors
Sandberg, A. A., & Bridge, J. A. (2003) · Cancer Genetics and Cytogenetics · doi:10.1016/s0165-4608(03)00105-5 · Cited by 261
Circular RNA circTADA2A promotes osteosarcoma progression and metastasis by sponging miR-203a-3p and regulating CREB3 expression
Wu, Y., Xie, Z., Chen, J., Chen, J., Ni, W., Ma, Y., Huang, K., Wang, G., Wang, J., Ma, J., et al. (2019) · Molecular Cancer · doi:10.1186/s12943-019-1007-1 · Cited by 264
UK guidelines for the management of bone sarcomas
On behalf of the British Sarcoma Group, Gerrand, C., Athanasou, N., Brennan, B., Grimer, R., Judson, I., Morland, B., Peake, D., Seddon, B., & Whelan, J. (2016) · Clinical Sarcoma Research · doi:10.1186/s13569-016-0047-1 · Cited by 258
Canine Osteosarcoma: A Naturally Occurring Disease to Inform Pediatric Oncology
Fenger, J. M., London, C. A., & Kisseberth, W. C. (2014) · ILAR Journal · doi:10.1093/ilar/ilu009 · Cited by 248
Neoadjuvant chemotherapy for high‐grade central osteosarcoma of the extremity: Histologic response to preoperative chemotherapy correlates with histologic subtype of the tumor
Bacci, G., Bertoni, F., Longhi, A., Ferrari, S., Forni, C., Biagini, R., Bacchini, P., Donati, D., Manfrini, M., Bernini, G., et al. (2003) · Cancer · doi:10.1002/cncr.11456 · Cited by 253
Immuno-genomic landscape of osteosarcoma
Wu, C.-C., Beird, H. C., Andrew Livingston, J., Advani, S., Mitra, A., Cao, S., Reuben, A., Ingram, D., Wang, W.-L., Ju, Z., et al. (2020) · Nature Communications · doi:10.1038/s41467-020-14646-w · Cited by 251
“(2) Calculate total number of aberrations (relative to diploid) for each sample (Ns) Ns 1⁄4 P44 i1⁄41 P2 j1⁄41 CNVi;j 1 where CNVi,j is absolute copy number in arm i and j”
Background
Inhibition of the CXCR4/CXCL12 chemokine pathway reduces the development of murine pulmonary metastases
Kim, S. Y., Lee, C. H., Midura, B., Yeung, C. L., Mendoza, A., Hong, S. H., Ren, L., Wong, D., Korz, W., Merzouk, A., et al. (2007) · Clinical & Experimental Metastasis · doi:10.1007/s10585-007-9133-3 · Cited by 253
“In osteosarcoma, 80% of metastases are to the lungs, 20% are to bone, and only rarely does osteosarcoma metastasize to any other organ [13].”
Background
Osteosarcoma in adolescents and adults: survival analysis with and without lung metastases
Aljubran, A. H., Griffin, A., Pintilie, M., & Blackstein, M. (2009) · Annals of Oncology · doi:10.1093/annonc/mdn731 · Cited by 230
“[5] analyzed 1702 patients with both metastatic and nonmetastatic osteosarcoma and reported similar survival rate with 5-year OS of 65.”
Background
A review of clinical and molecular prognostic factors in osteosarcoma
Clark, J. C. M., Dass, C. R., & Choong, P. (2007) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-007-0330-x · Cited by 250
“Clinical factors predictive of primary metastases include axial tumours, large tumours and a long history of symptoms (Bielack et al. 2002).”
BackgroundResultInfluential
Phase II Trial of Trastuzumab in Combination With Cytotoxic Chemotherapy for Treatment of Metastatic Osteosarcoma With Human Epidermal Growth Factor Receptor 2 Overexpression: A Report From the Children's Oncology Group
Ebb, D., Meyers, P., Grier, H., Bernstein, M., Gorlick, R., Lipshultz, S. E., Krailo, M., Devidas, M., Barkauskas, D. A., Siegal, G. P., et al. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.37.4546 · Cited by 243
“2-year event-free survival (EFS) rate of 15% to 20%.(2-5) Substantial improvements in the survival of”
Background
Novel Insights and Therapeutic Interventions for Pediatric Osteosarcoma
Kager, L., Tamamyan, G., & Bielack, S. (2016) · Future Oncology · doi:10.2217/fon-2016-0261 · Cited by 242
Self-citation
Common Musculoskeletal Tumors of Childhood and Adolescence
Arndt, C. A. S., Rose, P. S., Folpe, A. L., & Laack, N. N. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2012.01.015 · Cited by 298
“In the largest study of prognostic factors in OS, tumor site and size, presence of metastases, surgical remission, and tumor necrosis after neoadjuvant chemotherapy emerged as the most important independent prognostic factors.(36) Although the addition of ifosfamide and etoposide (IE) to the regimens of poor responder…”
Background
Second and Subsequent Recurrences of Osteosarcoma: Presentation, Treatment, and Outcomes of 249 Consecutive Cooperative Osteosarcoma Study Group Patients
Bielack, S. S., Kempf-Bielack, B., Branscheid, D., Carrle, D., Friedel, G., Helmke, K., Kevric, M., Jundt, G., Kühne, T., Maas, R., et al. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2008.16.2305 · Cited by 238
Self-citation
Surgical options for children with osteosarcoma
Grimer, R. J. (2005) · The Lancet Oncology · doi:10.1016/s1470-2045(05)01734-1 · Cited by 238
The Fascinating Effects of Baicalein on Cancer: A Review
Liu, H., Dong, Y., Gao, Y., Du, Z., Wang, Y., Cheng, P., Chen, A., & Huang, H. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17101681 · Cited by 236
Current Therapeutic Strategies and Novel Approaches in Osteosarcoma
Ando, K., Heymann, M., Stresing, V., Mori, K., Rédiní, F., & Heymann, D. (2013) · Cancers · doi:10.3390/cancers5020591 · Cited by 242
“The overall survival rate of these patients ranges from 10% to 50% [7,54,55], while that of patients with localized osteosarcoma is around 60% to 70% [27,85,86].”
Background
Children's Oncology Group's 2013 blueprint for research: Bone tumors
Gorlick, R., Janeway, K., Lessnick, S., Randall, R. L., Marina, N., & on behalf of the COG Bone Tumor Committee (2013) · Pediatric Blood & Cancer · doi:10.1002/pbc.24429 · Cited by 226
Update on Osteosarcoma
Belayneh, R., Fourman, M. S., Bhogal, S. S., & Weiss, K. R. (2021) · Current Oncology Reports · doi:10.1007/s11912-021-01053-7 · Cited by 230
Future Directions in the Treatment of Osteosarcoma
Smrke, A., Anderson, P. M., Gulia, A., Gennatas, S., Huang, P. H., & Jones, R. L. (2021) · Cells · doi:10.3390/cells10010172 · Cited by 230
“It is known that clinical behaviour and outcome of osteosarcoma varies on the basis of the primary site, age and whether it is primary versus radiation-associated [3,57].”
Background
Zoledronate in combination with chemotherapy and surgery to treat osteosarcoma (OS2006): a randomised, multicentre, open-label, phase 3 trial
Piperno-Neumann, S., Deley, M. L., Rédiní, F., Pacquement, H., Marec‐Bérard, P., Petit, P., Brisse, H. J., Lervat, C., Gentet, J., Entz‐Werlé, N., et al. (2016) · The Lancet Oncology · doi:10.1016/s1470-2045(16)30096-1 · Cited by 218
Current strategies of chemotherapy in osteosarcoma
Carrle, D., & Bielack, S. (2006) · International Orthopaedics · doi:10.1007/s00264-006-0192-x · Cited by 220
“However, recent reports from France [30] as well as those from our COSS group [5] have demonstrated that affected patients may survive with complete surgery and polychemotherapy, which, of course, needs to take into account previous chemotherapy exposure.”
BackgroundSelf-citation
An update on chemotherapy for osteosarcoma
Ferrari, S. M., & Serra, M. (2015) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2015.1102226 · Cited by 212
“2 Towards a tailored treatment for osteosarcoma Several prognostic factors have been described,[32,55] but none have been considered so powerful to be used for risk stratification of patients with osteosarcoma.”
Background
Osteosarcoma: The COSS Experience
Bielack, S., Jürgens, H., Jundt, G., Kevric, M., Kühne, T., Reichardt, P., Zoubek, A., Werner, M., Winkelmann, W., & Kotz, R. I. (2009) · Cancer treatment and research · doi:10.1007/978-1-4419-0284-9_15 · Cited by 212
“Another 23 patients died from causes other than osteosarcoma after having experienced a recurrence; for these, causes of death were myelotoxicity ( 10 ), perioperative complications after metastasectomy (4), cardiomyopathy (3), secondary hematologic malignancy (2), and hepatitis, anorexia, pulmonary fibrosis, and thro…”
BackgroundSelf-citation
Exosome-mediated miR-144-3p promotes ferroptosis to inhibit osteosarcoma proliferation, migration, and invasion through regulating ZEB1
Jiang, M., Jike, Y., Liu, K., Gan, F., Zhang, K., Xie, M., Zhang, J., Chen, C., Zou, X., Jiang, X., et al. (2023) · Molecular Cancer · doi:10.1186/s12943-023-01804-z · Cited by 212
Size Matters for Sarcomas!
Grimer, R. J. (2006) · Annals of The Royal College of Surgeons of England · doi:10.1308/003588406x130651 · Cited by 206
In Vitro and in Vivo Mechanism of Bone Tumor Inhibition by Selenium-Doped Bone Mineral Nanoparticles
Wang, Y., Wang, J., Hao, H., Cai, M., Wang, S., Ma, J., Li, Y., Mao, C., & Zhang, S. (2016) · ACS Nano · doi:10.1021/acsnano.6b03835 · Cited by 206
Survival from high-grade localised extremity osteosarcoma: combined results and prognostic factors from three European Osteosarcoma Intergroup randomised controlled trials
Whelan, J. S., Jinks, R. C., McTiernan, A., Sydes, M. R., Hook, J., Trani, L., Uscinska, B., Bramwell, V. H. C., Lewis, I. J., Nooij, M. A., et al. (2011) · Annals of Oncology · doi:10.1093/annonc/mdr491 · Cited by 207
“[4], included patients with primary metastatic and axial disease.”
BackgroundResultInfluential
Comparative biology of human and canine osteosarcoma.
Mueller, F., Fuchs, B., & Kaser‐Hotz, B. (2007) · PubMed · Cited by 203
Osteosarcoma and Metastasis
Sheng, G., Gao, Y., Yong, Y., & Wu, H. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.780264 · Cited by 215
“The OS cells show a high propensity to disseminate to develop metastasis, which appears to be the most important intrinsic factor for poor outcome of OS patients (5).”
Background
Delays in Cancer Diagnosis in Underinsured Young Adults and Older Adolescents
Martin, S., Ulrich, C., Munsell, M. F., Taylor, S. H., Lange, G., & Bleyer, A. (2007) · The Oncologist · doi:10.1634/theoncologist.12-7-816 · Cited by 200
“In Europe, population-based studies of breast cancer and osteosarcoma patients demonstrated a direct correlation between lagtime and stage at diagnosis [23, 24 ].”
Background
18F-FDG PET/CT as an Indicator of Progression-Free and Overall Survival in Osteosarcoma
Costelloe, C. M., Macapinlac, H. A., Madewell, J. E., Fitzgerald, N. E., Mawlawi, O. R., ROHREN, E. M., Raymond, A. K., Lewis, V. O., Anderson, P. M., Bassett, R. L., et al. (2009) · Journal of Nuclear Medicine · doi:10.2967/jnumed.108.058461 · Cited by 196
“Suboptimal histologic response to neoadjuvant chemotherapy, defined as less than 90% tumor necrosis (10,11), can also be an indication for more intensive adjuvant (postoperative) regimens (9,12).”
Background
Molecular alterations as target for therapy in metastatic osteosarcoma: a review of literature
PosthumaDeBoer, J., Witlox, A. M. A., Kaspers, G. J. L., & van Royen, B. J. (2011) · Clinical & Experimental Metastasis · doi:10.1007/s10585-011-9384-x · Cited by 194
“The 5-year survival rate for OS patients with metastases is 20% compared to 65% for patients with localised disease and most deaths associated with OS are the result of metastatic disease [5, 8–11].”
Background
Prognostic factors and outcomes for osteosarcoma: An international collaboration
Pakos, E. E., Nearchou, A. D., Grimer, R. J., Koumoullis, H., Abudu, A., Bramer, J. A. M., Jeys, L. M., Franchi, A., Scoccianti, G., Campanacci, D. A., et al. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2009.03.005 · Cited by 197
Neoadjuvant Chemotherapy With Methotrexate, Cisplatin, and Doxorubicin With or Without Ifosfamide in Nonmetastatic Osteosarcoma of the Extremity: An Italian Sarcoma Group Trial ISG/OS-1
Ferrari, S., Ruggieri, P., Cefalo, G., Tamburini, A., Capanna, R., Fagioli, F., Comandone, A., Bertulli, R., Bisogno, G., Palmerini, E., et al. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.38.4420 · Cited by 192
PET imaging of osteosarcoma.
Brenner, W., Bohuslavizki, K. H., & Eary, J. F. (2003) · PubMed · Cited by 190
Results of the Brazilian Osteosarcoma Treatment Group Studies III and IV: Prognostic Factors and Impact on Survival
Petrilli, A. S., de Camargo, B., Filho, V. O., Bruniera, P., Brunetto, A. L., Jesús-García, R., de Camargo, O. P., Pena, W., Baptista, P. P. R., Davi, A., et al. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.03.5352 · Cited by 188
Neoadjuvant chemotherapy for osteosarcoma of the extremities with metastases at presentation: recent experience at the Rizzoli Institute in 57 patients treated with cisplatin, doxorubicin, and a high dose of methotrexate and ifosfamide
Bacci, G., Briccoli, A., Rocca, M., Ferrari, S., Donati, D. M., Longhi, A., Bertoni, F., Bacchini, P., Giacomini, S., Forni, C., et al. (2003) · Annals of Oncology · doi:10.1093/annonc/mdg286 · Cited by 187
Benefits and Adverse Events in Younger Versus Older Patients Receiving Neoadjuvant Chemotherapy for Osteosarcoma: Findings From a Meta-Analysis
Collins, M. L., Wilhelm, M., Conyers, R. K., Herschtal, A., Whelan, J. S., Bielack, S., Kager, L., Kühne, T., Sydes, M. R., Gelderblom, H. A. J., et al. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.43.8598 · Cited by 186
Self-citation
The long-term results of endoprosthetic replacement of the proximal tibia for bone tumours
Myers, G. J. C., Abudu, A., Carter, S. R., Tillman, R. M., & Grimer, R. J. (2007) · Journal of Bone and Joint Surgery - British Volume · doi:10.1302/0301-620x.89b12.19481 · Cited by 184
Current Status and Future Perspectives on Neoadjuvant Therapy in Lung Cancer
Blumenthal, G. M., Bunn, P. A., Chaft, J. E., McCoach, C. E., Perez, E. A., Scagliotti, G. V., Carbone, D. P., Aerts, H. J. W. L., Aisner, D. L., Bergh, J. C. S., et al. (2018) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2018.09.017 · Cited by 188
Absence of a telomere maintenance mechanism as a favorable prognostic factor in patients with osteosarcoma.
Ulaner, G. A., Huang, H.-Y., Otero, J. E., Zhao, Z., Ben‐Porat, L., Satagopan, J. M., Gorlick, R. G., Meyers, P. A., Healey, J. H., Huvos, A. G., et al. (2003) · PubMed · Cited by 181
Outcome for adolescent and young adult patients with osteosarcoma
Janeway, K. A., Barkauskas, D. A., Krailo, M., Meyers, P. A., Schwartz, C. L., Ebb, D. H., Seibel, N. L., Grier, H. E., Gorlick, R. G., & Marina, N. M. (2012) · Cancer · doi:10.1002/cncr.27414 · Cited by 178
“in younger patients,(9) and still others reporting a lack of association between age and prognosis.(10,11) One important methodological consideration contributing to variable results is the manner in which age has been converted to a categorical variable.”
BackgroundResultInfluential
Prognostic factors in localized extremity osteosarcoma: A systematic review
Bramer, J. A. M., van Linge, J. H., Grimer, R. J., & Scholten, R. J. P. M. (2009) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2009.01.011 · Cited by 177
“In the group of patients with an extremity osteosarcoma Bielack et al.(6) finds inadequate surgical margin, poor chemotherapy response, proximal tumor location, and tumor”
Influential
Risk Factors for Metastatic Disease at Presentation with Osteosarcoma
Miller, B. J., Cram, P. M., Lynch, C. F., & Buckwalter, J. A. (2013) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.l.01189 · Cited by 177
Long-term survival after aggressive resection of pulmonary metastases among children and adolescents with osteosarcoma
Harting, M. T., Blakely, M. L., Jaffe, N., Cox, C. S., Hayes-Jordan, A. A., Benjamin, R. S., Raymond, A. K., Andrassy, R. J., & Lally, K. P. (2006) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2005.10.089 · Cited by 173
Survival Data for 648 Patients with Osteosarcoma Treated at One Institution
Mankin, H. J., Hornicek, F. J., Rosenberg, A. E., Harmon, D. C., & Gebhardt, M. C. (2004) · Clinical Orthopaedics and Related Research · doi:10.1097/01.blo.0000145991.65770.e6 · Cited by 175
“In 2001, Bacci et al(2) reported a 67% success rate for 140 patients, and in 2002, a cooperative group in Germany reported a 60% survival rate for 570 patients with osteosarcoma.(7,79) Several studies have shown that patients with pelvic lesions have a poor prognosis.”
Background
Osteosarcoma Genetics and Epigenetics: Emerging Biology and Candidate Therapies
Morrow, J. J., & Khanna, C. (2015) · Critical Reviews™ in Oncogenesis · doi:10.1615/critrevoncog.2015013713 · Cited by 176
Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII
Smeland, S., Müller, C., Alvegård, T. A., Wiklund, T. A., Wiebe, T., Björk, O., Stenwig, A. E., Willén, H., Holmström, T., Follerås, G., et al. (2003) · European Journal of Cancer · doi:10.1016/s0959-8049(02)00747-5 · Cited by 165
CircMYO10 promotes osteosarcoma progression by regulating miR-370-3p/RUVBL1 axis to enhance the transcriptional activity of β-catenin/LEF1 complex via effects on chromatin remodeling
Chen, J., Liu, G., Wu, Y., Ma, J., Wu, H.-F., Xie, Z., Chen, S., Yang, Y., Wang, S., Shen, P., et al. (2019) · Molecular Cancer · doi:10.1186/s12943-019-1076-1 · Cited by 164
“Although the overall 5-year survival rate of patients with OS has increased from 10 to 70% with the application of chemotherapy and surgery over the last 30 years, prognosis remains poor for cases displaying metastasis or drug resistance [4].”
Background
Intercalary Allograft Reconstructions Following Resection of Primary Bone Tumors
Bus, M. P. A., Dijkstra, P. D. S., van de Sande, M. A. J., Taminiau, A. H. M., Schreuder, H. W. B., Jutte, P. C., van der Geest, I. C. M., Schaap, G. R., & Bramer, J. A. M. (2014) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.m.00655 · Cited by 160
“Localization within bone piece Diaphyseal 43 (49) 38 (49) Metadiaphyseal 35 (40) 31 (40) Epidiaphyseal 9 (10) 9 (12)”
PLK1shRNA and doxorubicin co-loaded thermosensitive PLGA-PEG-PLGA hydrogels for osteosarcoma treatment
Ma, H., He, C., Cheng, Y., Li, D., Gong, Y., Liu, J., Tian, H., & Chen, X. (2014) · Biomaterials · doi:10.1016/j.biomaterials.2014.06.045 · Cited by 160
“Typically, the primary sites of osteosarcoma are the distal femur, the proximal tibia, and the distal humerus, with 64% originating from the knee [3].”
Background

Authors: Bielack, S. S., Kempf-Bielack, B., Delling, G., Exner, G. U., Flege, S., Helmke, K., Kotz, R., Salzer-Kuntschik, M., Werner, M., Winkelmann, W., Zoubek, A., Jürgens, H., & Winkler, K.
Affiliations: University of Münster (DE)
Corresponding author: Bielack, Stefan S.
ORCID: Bielack, Stefan S.
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2002-02-01
Volume: 20
Issue: 3
Pages: 776-790
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2002.20.3.776
OpenAlex: W2148077417
Cited by: 2,393
References: 61
Citations by year: 2026: 85 · 2025: 95 · 2024: 112 · 2023: 162 · 2022: 159 · 2021: 167 · 2020: 166 · 2019: 121 · 2018: 114 · 2017: 106 · 2016: 122 · 2015: 139 · 2014: 124 · 2013: 106 · 2012: 75
FWCI: 34.99
Type: journal article
Language: en
Update notices: new_edition (2023-09-15)
Open access: closed
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Oncology › Sarcoma Diagnosis and Treatment
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone Tumor Diagnosis and Treatments
Health Sciences › Medicine › Oncology › Ovarian cancer diagnosis and treatment
Keywords: high-grade osteosarcoma, prognostic factors, neoadjuvant chemotherapy, limb-sparing surgery, tumor location, tumor size, chemotherapy response, surgical remission, event-free survival, overall survival, histological response, patient age, sex differences
MeSH terms: Adolescent, Adult, Aged, Bone Neoplasms, Child, Child, Preschool, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Osteosarcoma, Survival Rate, Multivariate Analysis, Chemotherapy, Adjuvant

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks