CoChat
Sign Up
Cited by 643Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsManagement of metastatic bone disease

Osteosarcoma Relapse After Combined Modality Therapy: An Analysis of Unselected Patients in the Cooperative Osteosarcoma Study Group (COSS)

Kempf-Bielack, Beate, Bielack, Stefan S., Jürgens, Heribert, Branscheid, Detlev, Berdel, Wolfgang E., Exner, G. Ulrich, Göbel, Ulrich, Helmke, Knut +11 more·2005·Journal of Clinical Oncology
DOI 10.1200/jco.2005.04.063
Open this paper in CoChat — free account

Abstract

Purpose: To evaluate the impact of patient, tumor, and treatment-related factors on outcome in unselected patients with recurrent osteosarcoma. Patients and Methods: Five hundred seventy-six consecutive patients who had achieved a first complete surgical remission (CR) during combined-modality therapy on neoadjuvant Cooperative Osteosarcoma Study Group (COSS) protocols and then developed recurrent osteosarcoma were analyzed (median time from biopsy to relapse, 1.6 years; range, 0.1 to 14.3 years). There were 501 patients with metastases, 44 with local recurrences, and 31 with both. Metastases involved lungs (469 patients), bones (90 patients), and/or other sites (54 patients). Results: After a median follow-up of 1.2 years for all patients and 4.2 years for survivors, actuarial overall survival (OS) rates at 2, 5, and 10 years were 0.38, 0.23, and 0.18, respectively. Five-year OS was 0.39 for 339 patients with and 0.00 for 229 patients without a second surgical CR (P < .0001). A long time to relapse, a solitary lesion, and, in the case of pulmonary metastases, unilateral disease and the absence of pleural disruption, were of positive prognostic value in uni- and multivariate analyses, as were a second surgical CR and the use of second-line chemotherapy. Radiotherapy was associated with moderately prolonged survival in patients without a second CR. The very limited prognostic differences associated with the use of second-line chemotherapy appeared to be more pronounced with polychemotherapy. Conclusion: Time to relapse and tumor burden correlate with postrelapse outcome in osteosarcoma. Complete surgery is an essential component of curative second-line therapy. Chemotherapy, particularly chemotherapy with more than one agent, may contribute to limited improvements in outcome.

Integrity signals

Registry

Crossref · 10.1200/jco.2005.04.063

Cites

46 of 46 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?

  • Systemic therapy in second and later lines seems to produce a limited prolongation in survival.

    “Still, systemic therapy in second and later lines seems to produce a limited prolongation in survival [11, 12], and new therapeutic approaches are needed.”

    From Pembrolizumab in advanced osteosarcoma: results of a single-arm, open-label, phase 2 trial (2021) · cites this paper as [12]

  • Patients with unresectable primary or metastatic disease at diagnosis and those with disease relapse have extremely poor outcomes.

    “In addition, patients with unresectable primary or metastatic disease at diagnosis and those with disease relapse have extremely poor outcomes 2,126 .”

    From Osteosarcoma (2022) · cites this paper as [126]

  • Second complete remission, which is only achievable through surgery, has a strong association with improved outcomes after relapse in retrospective studies.

    “This second complete remission, which is only achievable through surgery, has a strong association with improved outcomes after relapse in retrospective studies 126 .”

    From Osteosarcoma (2022) · cites this paper as [126]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Kempf-Bielack, B., Bielack, S. S., Jürgens, H., Branscheid, D., Berdel, W. E., Exner, G. U., Göbel, U., Helmke, K., Jundt, G., Kabisch, H., Kevric, M., Klingebiel, T., Kotz, R., Maas, R., Schwarz, R., Semik, M., Treuner, J., Zoubek, A., & Winkler, K.
Affiliations
  • From the Universitätsklinikum Münster, Klinik und Poliklinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie; Universitätsklinikum Münster, Medizinische Klinik und Poliklinik A; Universitätsklinikum Münster, Klinik und Poliklinik für Thorax-, Herz- und Gefäβchirurgie, Münster; Krankenhaus Groβhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Groβhansdorf; Universitätsklinikum Düsseldorf, Klinik für Kinder-Onkologie, -Hämatologie und -Immunologie, Düsseldorf;...
  • Düsseldorf University Hospital (DE)
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2005-01-20
Volume
23
Issue
3
Pages
559-568
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2005.04.063
OpenAlex
W2141788705
Cited by
643
References
46
Citations by year
2026: 17 · 2025: 19 · 2024: 24 · 2023: 29 · 2022: 43 · 2021: 54 · 2020: 55 · 2019: 27 · 2018: 32 · 2017: 53 · 2016: 38 · 2015: 36 · 2014: 38 · 2013: 25 · 2012: 24
FWCI
13.19
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Merck KGaA
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
  • Health Sciences › Medicine › Surgery › Management of metastatic bone disease
Keywords
osteosarcoma, relapse, recurrent osteosarcoma, multimodal therapy, lung metastasis, prognostic factors, second-line chemotherapy, radiotherapy, overall survival, tumor burden, time to relapse
MeSH terms
Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bone Neoplasms, Child, Child, Preschool, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Risk Factors, Osteosarcoma, Time Factors, Cohort Studies, Survival Analysis

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