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Camacho M, Carvalho M, Munhoz R, Etchebehere M, Etchebehere E. FDG PET/CT in bone sarcomas. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cao Z, Zhang Y, Xu Q, Yu X, Liu X, Dai M. The Role of Chemotherapy in the Survival Benefits of Patients Aged Older Than 40 Years With Osteosarcoma. Technol Cancer Res Treat 2021; 20:15330338211066195. [PMID: 34918558 PMCID: PMC8721374 DOI: 10.1177/15330338211066195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: The value of chemotherapy in the survival benefits of patients aged > 40 years with osteosarcoma is controversial. We aimed to explore the impact of chemotherapy on the survival benefits of patients aged >40 years with osteosarcoma. Methods: The Surveillance, Epidemiology, and End Results database was used to select eligible patients. The selected patients were divided into the chemotherapy and non-chemotherapy groups. Logistic regression analysis was performed to investigate the potential factors contributing to the selection of chemotherapy. The overall survival (OS) and cancer-specific survival (CSS) of the two groups were compared using the Kaplan–Meier method with a log-rank test. Cox proportional risk models were used to determine the prognostic factors for OS and CSS. Stratified analysis was performed according to tumour grade and stage. Results: A total of 1032 eligible patients were included in our analysis. Of these, 586 and 446 patients were in the chemotherapy and nonchemotherapy groups, respectively. Multivariate logistic analysis indicated that grade III/IV and distant stage were associated with chemotherapy. Kaplan–Meier plots showed that patients did not achieve an improved OS or CSS after receiving chemotherapy. Cox regression analysis indicated that age > 60 years, axial, grade III/IV, and regional and distant stage were independent risk factors for poor prognosis in both OS and CSS. Stratified analysis revealed a survival benefit from chemotherapy in patients with grade III/IV and distant stage. Conclusions: Chemotherapy did not significantly improve OS and CSS in patients aged > 40 years with osteosarcoma. In this age group, survival benefit from chemotherapy was observed in patients with high-grade tumours (grade III/IV) and metastasis (distant stage).
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Affiliation(s)
- Zhiyou Cao
- 117970The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuelin Zhang
- Shangrao Municipal Hospital, ShangRao, Jiangxi, China
| | - Qiang Xu
- 117970The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaolong Yu
- 117970The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xuqiang Liu
- 117970The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Min Dai
- 117970The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Liu X, He S, Yao X, Hu T. Development and Validation of Prognostic Nomograms for Elderly Patients with Osteosarcoma. Int J Gen Med 2021; 14:5581-5591. [PMID: 34548809 PMCID: PMC8449646 DOI: 10.2147/ijgm.s331623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background The aim of the current study was to construct prognostic nomograms for individual risk prediction in elderly patients with osteosarcoma. Methods Data for 816 elderly patients (≥40 years old) with osteosarcoma between 2004 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database were randomly assigned to training (N=573) and internal validation (N=243) sets. The essential clinical predictors were identified based on least absolute shrinkage and selection operator (Lasso) Cox regression. Nomograms were constructed to predict the 1-, 3-, and 5-year cancer-specific survival (CSS) and overall survival (OS). Results Our LASSO regression analyses of the training set yielded five clinicopathological features (age, chemotherapy, surgery, AJCC stage, and summary stage) in the training cohort for the prognosis of elderly patients with osteosarcoma, while grade was only associated with OS and M stage was only associated with CSS. Construction of nomograms based on these predictors was performed to evaluate the prognosis of elderly patients with osteosarcoma. The C-index, calibration and decision curve analysis also showed the satisfactory performance of these nomograms for prognosis prediction. Conclusion The constructed nomograms are helpful tools for exactly predicting the prognosis of elderly patients with osteosarcoma, which could enable patients to be more accurately managed in clinical practice.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Orthopedic Surgery, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Shaoya He
- Department of Gastroenterology, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Xi Yao
- Department of Orthopedic Surgery, Anyue County People's Hospital, Sichuan, People's Republic of China
| | - Tianyang Hu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Takenaka S, Tamiya H, Wakamatsu T, Nakai S, Imura Y, Outani H, Yagi T, Kawai A. Impact of Surgical Resection and Reasons for Poor Prognosis of Pelvic Osteosarcoma Based on the Bone Tumor Registry in Japan. Cancers (Basel) 2021; 13:cancers13133320. [PMID: 34282764 PMCID: PMC8268378 DOI: 10.3390/cancers13133320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Pelvic osteosarcoma has a poor prognosis compared to osteosarcomas in other locations, and the reasons for this remains unknown. Surgical resection of pelvic osteosarcoma is technically demanding and often results in dysfunction and complications. In this study, we investigated the reasons underlying the poor prognosis of pelvic osteosarcoma by comparing it to femoral osteosarcoma using data from the Bone Tumor Registry in Japan. We used propensity score analysis to determine whether surgical resection of pelvic osteosarcoma improved its prognosis. We demonstrated that pelvic osteosarcoma had a poor prognosis because it occurred more often in the elderly, often had a larger tumor size, and had metastasis at presentation more often in comparison to femoral osteosarcoma. These three factors were also associated with the non-surgical treatment of pelvic osteosarcoma, which also led to a poor outcome. The overall survival rate was only comparable in pelvic osteosarcoma and femoral osteosarcoma in cases treated with surgical resection. Propensity score analysis revealed that surgical treatment improved the prognosis of pelvic osteosarcoma. As such, we propose that surgical resection should be considered based on tumor stage and patient age in order to improve the prognosis of pelvic osteosarcoma. Abstract Pelvic osteosarcoma has a poor prognosis compared to osteosarcomas in other locations, and the reasons for this remain unknown. Surgical resection of pelvic osteosarcoma is technically demanding and often results in dysfunction and complications. In this study, we investigated the reasons underlying the poor prognosis of pelvic osteosarcoma by comparing it to femoral osteosarcoma using data from the Bone Tumor Registry in Japan. We used propensity score analysis to determine whether surgical resection of pelvic osteosarcoma improved its prognosis. We demonstrated that pelvic osteosarcoma had a poor prognosis because it occurred more often in the elderly, often had larger tumor size, and had metastasis at presentation more often in comparison to femoral osteosarcoma. These three factors were also associated with the non-surgical treatment of pelvic osteosarcoma, which also led to a poor outcome. The overall survival rate was only comparable in pelvic osteosarcoma and femoral osteosarcoma in cases treated with surgical resection. Propensity score analysis revealed that surgical treatment improved the prognosis of pelvic osteosarcoma. As such, we propose that surgical resection should be considered based on tumor stage and patient age in order to improve the prognosis of pelvic osteosarcoma.
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Affiliation(s)
- Satoshi Takenaka
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan; (H.T.); (T.W.); (S.N.); (T.Y.)
- Correspondence: ; Tel.: +81-6-6945-1181
| | - Hironari Tamiya
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan; (H.T.); (T.W.); (S.N.); (T.Y.)
| | - Toru Wakamatsu
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan; (H.T.); (T.W.); (S.N.); (T.Y.)
| | - Sho Nakai
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan; (H.T.); (T.W.); (S.N.); (T.Y.)
| | - Yoshinori Imura
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.I.); (H.O.)
| | - Hidetatsu Outani
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (Y.I.); (H.O.)
| | - Toshinari Yagi
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka 541-8567, Japan; (H.T.); (T.W.); (S.N.); (T.Y.)
| | - Akira Kawai
- Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center, Tokyo 104-0045, Japan;
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Hayakawa K, Matsumoto S, Ae K, Tanizawa T, Funauchi Y, Minami Y, Saito M, Okawa A. Definitive surgery of primary lesion should be prioritized over preoperative chemotherapy to treat high-grade osteosarcoma in patients aged 41-65 years. J Orthop Traumatol 2020; 21:13. [PMID: 32865641 PMCID: PMC7458972 DOI: 10.1186/s10195-020-00552-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 07/27/2020] [Indexed: 12/03/2022] Open
Abstract
Background Recently, the number of osteosarcomas in middle-aged and older patients has demonstrated an increasing trend; moreover, their results are comparatively worse than those of young patients. In Europe and the USA, the prognosis for osteosarcoma in middle-aged and older patients has improved with adjuvant chemotherapy. In Japan, however, the prognosis has remained poor. Materials and Methods We retrospectively analyzed the outcomes of osteosarcoma, especially in regards to preoperative chemotherapy, from January 1980 to July 2014. A total of 29 patients with high-grade osteosarcoma between the age of 40 and 65 years were included. We included patients without distant metastasis and with primary lesions that were deemed resectable. The mean age was 52.8 years (range 41–65 years), and the mean follow-up period was 103.2 months (range 5–314 months). Results Adjuvant chemotherapy was administered to 27 of 29 patients (93%), and 8 of 15 cases (53%) were able to undergo preoperative chemotherapy as planned, including CDDP. A major complication of chemotherapy was acute kidney injury due to CDDP (26%). The 5-year OS and 5-year EFS were 64.9% and 57.1%, respectively. After 2006, a policy to prioritize the resection of the primary lesion was implemented, and if the primary lesion was deemed resectable, preoperative chemotherapy was either not administered or administered for only a short duration. The 5-year OS after 2006 improved to 78.8%. Conclusions This study shows that administration of high-dose intensity preoperative chemotherapy was difficult in middle-aged and older patients due to their high rate of acute kidney injury by CDDP. For cases of osteosarcoma in middle-aged and older patients, if the primary lesion is resectable, preoperative chemotherapy should be minimized to prioritize the resection of the primary lesion. It was considered that, with appropriate measures to prevent complications, adjuvant chemotherapy may lead to improved prognosis. Level of evidence V.
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Affiliation(s)
- Keiko Hayakawa
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Seiichi Matsumoto
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Keisuke Ae
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Taisuke Tanizawa
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yuki Funauchi
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yusuke Minami
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masanori Saito
- Department of Orthopedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Atsushi Okawa
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Nagano A, Matsumoto S, Kawai A, Okuma T, Hiraga H, Matsumoto Y, Nishida Y, Yonemoto T, Hosaka M, Takahashi M, Yoshikawa H, Kunisada T, Asanuma K, Naka N, Emori M, Kubo T, Kawashima H, Kawamoto T, Yokoyama R, Tsukushi S, Sato K, Okamoto T, Hiraoka K, Morioka H, Tanaka K, Takagi T, Iwamoto Y, Ozaki T. Osteosarcoma in patients over 50 years of age: Multi-institutional retrospective analysis of 104 patients. J Orthop Sci 2020; 25:319-323. [PMID: 31155441 DOI: 10.1016/j.jos.2019.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 03/02/2019] [Accepted: 04/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. METHODS This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. RESULTS Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8%) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6% and 71.7%, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2% and 43.6%, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. CONCLUSIONS The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.
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Affiliation(s)
- Akihito Nagano
- The Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1193, Japan.
| | - Seiichi Matsumoto
- The Department of Orthopaedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akira Kawai
- The Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tomotake Okuma
- The Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Hiroaki Hiraga
- The Department of Orthopaedic Surgery, Hokkaido Cancer Center, 4-2-3-54 Kikusui 4-2, 3-54, Shiroishiku, Sapporo, 003-0804, Japan
| | - Yoshihiro Matsumoto
- The Department of Orthopaedic Surgery, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan
| | - Yoshihiro Nishida
- The Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Tsukasa Yonemoto
- The Department of Orthopaedic Surgery, Chiba Cancer Center Hospital, 666-2 Nitona-cho Chuo-ku Chiba, 260-8717, Japan
| | - Masami Hosaka
- The Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Mitsuru Takahashi
- The Department of Orthopaedic Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref. 411-8777, Japan
| | - Hideki Yoshikawa
- The Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toshiyuki Kunisada
- The Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kunihiro Asanuma
- The Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi Tsu, Mie, 5148507, Japan
| | - Norifumi Naka
- The Department of Orthopaedic Surgery, Osaka International Cancer Center, 3-1-69, Otemae, Chuo-ku, Osaka-shi, Osaka 541-8567, Japan
| | - Makoto Emori
- The Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Tadahiko Kubo
- The Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima 734-8553, Japan
| | - Hiroyuki Kawashima
- The Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Niigata University, 757 Ichibancho, Asahimachi-dori, Chuo Ward, Niigata City, 951-8510, Japan
| | - Teruya Kawamoto
- The Department of Orthopaedic Surgery, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo Prefecture, 650-0017, Japan
| | - Ryohei Yokoyama
- The Department of Orthopedic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Satoshi Tsukushi
- The Department of Orthopaedic Surgery, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku Nagoya, 464-8681, Japan
| | - Kenji Sato
- The Department of Orthopaedic Surgery, Teikyo University, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8605, Japan
| | - Takeshi Okamoto
- The Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Koji Hiraoka
- The Department of Orthopaedic Surgery, Kurume University, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideo Morioka
- The Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuhiro Tanaka
- The Department of Endoprosthetic Surgery, Oita University, 1-1 Idaigaoka, Hazama-cho, Yufu, Oita 879-5593, Japan
| | - Tatsuya Takagi
- The Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yukihide Iwamoto
- Kyushu Rosai Hospital, 1-1 Sonekitamachi, Kokuraminami-ku, Kitakyusyu, 800-0296, Japan
| | - Toshifumi Ozaki
- The Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
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Xu Q, Gao T, Zhang B, Zeng J, Dai M. Primary osteosarcoma in elderly patients: A report of three cases. Oncol Lett 2019; 18:990-996. [PMID: 31423158 PMCID: PMC6607338 DOI: 10.3892/ol.2019.10446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 03/07/2019] [Indexed: 02/04/2023] Open
Abstract
Osteosarcoma is the most common type of primary malignant bone tumor in children and young adults. However, primary osteosarcoma in elderly patients is rare. The present study reports 3 cases of advanced osteosarcoma in elderly patients. The pathological findings in all 3 cases confirmed the diagnosis of primary osteosarcoma. Notably, each patient received different treatment options. Chemoradiotherapy was recommended in case 1 due to the age of the patient. However, the patient requested to be discharged and was lost to follow-up. Conversely, in case 2, the 62-year-old female patient underwent systemic chemotherapy, but no surgical treatment, and in case 3, the 51-year-old male patient underwent complete tumor resection and received systemic chemotherapy for late tumor recurrence. Early diagnosis of osteosarcoma in elderly patients is difficult, and misdiagnosis or a missed diagnosis is common. In clinical practice, bone tumors in elderly patients should be investigated carefully. Imaging examinations are essential for diagnosis, and biopsy is required for confirmation. However, the efficacy of chemotherapy for elderly patients with primary osteosarcoma remains uncertain. Collectively, due to the small number of reports of osteosarcoma in the elderly population, the 3 cases in the present study raise awareness of this rare condition.
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Affiliation(s)
- Qiang Xu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Tian Gao
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Jin Zeng
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi 330006, P.R. China
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Toki S, Kobayashi E, Yoshida A, Ogura K, Wakai S, Yoshimoto S, Yonemori K, Kawai A. A clinical comparison between dedifferentiated low-grade osteosarcoma and conventional osteosarcoma. Bone Joint J 2019; 101-B:745-752. [PMID: 31154837 DOI: 10.1302/0301-620x.101b6.bjj-2018-1207.r1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The purpose of this study was to clarify the clinical behaviour, prognosis, and optimum treatment of dedifferentiated low-grade osteosarcoma (DLOS) diagnosed based on molecular pathology. PATIENTS AND METHODS We retrospectively reviewed 13 DLOS patients (six men, seven women; median age 32 years (interquartile range (IQR) 27 to 38)) diagnosed using the following criteria: the histological coexistence of low-grade and high-grade osteosarcoma components in the lesion, and positive immunohistochemistry of mouse double minute 2 homolog (MDM2) and cyclin-dependent kinase 4 (CDK4) associated with MDM2 amplification. These patients were then compared with 51 age-matched consecutive conventional osteosarcoma (COS) patients (33 men, 18 women; median age 25 years (IQR 20 to 38)) regarding their clinicopathological features. RESULTS The five-year overall survival (OAS) rates in the DLOS and COS patients were 85.7% and 77.1% (p = 0.728), respectively, and the five-year progression-free survival (PFS) rates were 57.7% and 44.9% (p = 0.368), respectively. A total of 12 DLOS patients received chemotherapy largely according to regimens for COS. Among the nine cases with a histological evaluation after chemotherapy, eight showed a poor response, and seven of these had a necrosis rate of < 50%. One DLOS patient developed local recurrence and five developed distant metastases. CONCLUSION Based on our study of 13 DLOS cases that were strictly defined by histological and molecular means, DLOS showed a poorer response to a standard chemotherapy regimen than COS, while the clinical outcomes were not markedly different. Cite this article: Bone Joint J 2019;101-B:745-752.
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Affiliation(s)
- S Toki
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan; Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - E Kobayashi
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - A Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - K Ogura
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Wakai
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - S Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - K Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
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Imura Y, Takenaka S, Kakunaga S, Nakai T, Wakamatsu T, Outani H, Tanaka T, Tamiya H, Oshima K, Hamada K, Naka N, Araki N, Kudawara I, Ueda T, Yoshikawa H. Survival analysis of elderly patients with osteosarcoma. INTERNATIONAL ORTHOPAEDICS 2019; 43:1741-1747. [PMID: 31011764 DOI: 10.1007/s00264-019-04332-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/31/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Few studies have described the characteristics and prognostic factors of elderly patients with osteosarcoma. We retrospectively investigated clinico-pathological features and prognostic factors in osteosarcoma patients > 40 years old. METHODS Patients with high-grade osteosarcoma > 40 years old who were treated at our institutions from 2000 to 2016 were recruited for this study. Information on patient, tumour, and treatment-related factors was collected and statistically analyzed. The median follow-up was 26.5 months (range, 5-139 months) for all patients. RESULTS Fifty patients (30 males and 20 females) were included. The median age at diagnosis was 59.5 years (range, 41-81 years). The primary lesions were found in the limbs in 32 patients, trunk in 12, and craniofacial bones in six. Primary and secondary osteosarcoma occurred in 41 and 9 patients, respectively. Eight patients exhibited initial distant metastasis. Definitive surgery and chemotherapy were performed in 39 patients each. The rate of good responders after neoadjuvant chemotherapy was 38%. The five year overall survival (OS) rates for all patients and those without distant metastasis at diagnosis were 44.5% and 51.1%, respectively. Multivariate analysis showed that definitive surgery was the only significant prognostic factor in non-metastatic patients. The five year OS and disease-free survival (DFS) rates for non-metastatic patients who received definitive surgery were 64.3% and 60%, respectively. Among these patients, neoadjuvant and/or adjuvant chemotherapy significantly improved both OS and DFS. CONCLUSIONS Complete surgical resection and intensive chemotherapy should be performed for osteosarcoma patients > 40 years old despite distinct clinicopathological characteristics from those of younger patients.
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Affiliation(s)
- Yoshinori Imura
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | - Satoshi Takenaka
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shigeki Kakunaga
- Department of Orthopedic Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Takaaki Nakai
- Department of Orthopedic Surgery, Kawachi General Hospital, 1-31 Yokomakura, Higashi-Osaka, Osaka, 578-0955, Japan
| | - Toru Wakamatsu
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hidetatsu Outani
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takaaki Tanaka
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hironari Tamiya
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kazuya Oshima
- Department of Orthopedic Surgery, Bell-land General Hospital, 500-3 Higashiyama, Naka-ku, Sakai, Osaka, 599-8247, Japan
| | - Kenichiro Hamada
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Norifumi Naka
- Musculoskeletal Oncology Service, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Nobuhito Araki
- Department of Orthopedic Surgery, Ashiya Municipal Hospital, 39-1 Asahigaoka-Cho, Ashiya, Hyogo, 659-8502, Japan
| | - Ikuo Kudawara
- Department of Orthopedic Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Takafumi Ueda
- Department of Orthopedic Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Hideki Yoshikawa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Tempelaere C, Biau D, Babinet A, Anract P. Osteosarcoma after the age of fifty: A clinicopathological study. Eur J Surg Oncol 2019; 45:1288-1292. [PMID: 31014986 DOI: 10.1016/j.ejso.2019.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/05/2019] [Accepted: 04/12/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Osteosarcoma, a primary malignant bone tumor, has a well-recognised double peak of incidence in early adolescence and after 50 years. This study investigates the clinical features and prognostic factors of patients older than 50 years with osteosarcoma. MATERIEL AND METHODS From January 2000 to December 2012, in one bone tumor reference center, 32 patients aged more than 50 years at the diagnosis (mean age: 62.4 years (50-85), sex ratio: 13 males, 19 females) diagnosed with osteosarcoma were included. Patients younger than 50 years at diagnosis or with a non-histologically proved osteosarcoma were excluded. For each patient, we registered medical history, tumor location, systemic and local extension, treatment, and survival. RESULTS 62% were located in the extremities and 28% in the axial skeleton. 6 were secondary sarcomas. Mean delay between first symptoms and biopsy was 7.4 months (range from 0 to 28 months). Ten patients had a systemic osteosarcoma with one or more pulmonary metastases. Six patients were treated with palliative care (18.8%). Eighteen patients received neodajuvant chemotherapy, sixteen of them received postoperative chemotherapy. Twenty-five patients had surgery. Postoperative complications were reported in eight cases (25%). Overall survival for all 31 patients was 25% at 5 years and 6.2% at 10 years. Survival without metastases was 15.6% at 5 years and nil at 10 years. Median survival time for the 22 localised osteosarcoma patients was 4 years (0.9-12.6) versus 1.2 years (0.3-12.3) for the 10 systemic osteosarcoma patients (p = 0.01). CONCLUSION Metastases at diagnosis, age, axial location are worse prognostic for survival.
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Affiliation(s)
- Christine Tempelaere
- Service d'orthopédie, Hôpital Cochin, AP-HP, Paris, France, Université Paris Descartes, Paris, France.
| | - David Biau
- Service d'orthopédie, Hôpital Cochin, AP-HP, Paris, France, Université Paris Descartes, Paris, France
| | - Antoine Babinet
- Service d'orthopédie, Hôpital Cochin, AP-HP, Paris, France, Université Paris Descartes, Paris, France
| | - Philippe Anract
- Service d'orthopédie, Hôpital Cochin, AP-HP, Paris, France, Université Paris Descartes, Paris, France
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Tsuchie H, Emori M, Nagasawa H, Miyakoshi N, Murahashi Y, Shimizu J, Mizushima E, Yamashita T, Shimada Y. Prognosis of Primary Osteosarcoma in Elderly Patients: A Comparison between Young and Elderly Patients. Med Princ Pract 2019; 28:425-431. [PMID: 30991396 PMCID: PMC6771043 DOI: 10.1159/000500404] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/16/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Osteosarcoma is the most common malignant bone tumor in childhood. Although a poorer prognosis has been described in older patients, few reports have focused solely on primary osteosarcoma. We evaluated the clinical features of elderly patients with primary osteosarcoma. MATERIALS AND METHODS Ninety-four patients were included in this retrospective study, and we divided them into 2 groups (older patients and younger patients) based on a cut-off age of 40 years. The patients' information, including age, tumor type, location, presence of metastasis, American Joint Committee on Cancer (AJCC) stage, treatment-related factors, local and distant relapse, and outcome, was collected. We compared the clinical courses between the 2 groups in all and only deceased patients. RESULTS In all patients, the frequency of chemotherapy in the older group was significantly lower than in the younger group (p < 0.001), and tumors were more frequent in axial bone in the older patients (p = 0.041). Only in patients with surgical treatment, histological effectiveness after chemotherapy in the older group was lower than in the younger group (p = 0.041). The older patients showed a poorer prognosis (p = 0.031). However, the 5-year overall survival rate in the older patients was more favorable than that in the younger patients only among deceased patients (p =0.032). Only the existence of metastasis affected the prognosis in older patients (p = 0.012). CONCLUSION Primary osteosarcoma in elderly patients showed a high incidence of axial bone involvement, a low rate of chemotherapy, and resistance to chemotherapy. Although the final life prognosis is poor, survival may be relatively prolonged.
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Affiliation(s)
- Hiroyuki Tsuchie
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan,
| | - Makoto Emori
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroyuki Nagasawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yasutaka Murahashi
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Junya Shimizu
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Emi Mizushima
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshihiko Yamashita
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoichi Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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12
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Liu HF, Wang JX, Zhang DQ, Lan SH, Chen QX. Clinical Features and Prognostic Factors in Elderly Ewing Sarcoma Patients. Med Sci Monit 2018; 24:9370-9375. [PMID: 30580374 PMCID: PMC6320658 DOI: 10.12659/msm.911882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Elderly patients with Ewing sarcoma have a very poor prognosis, and treatment remains a challenge. However, the outcomes and potential prognostic factors of elderly Ewing sarcoma patients are rarely documented. Therefore, we investigated the prognosis of this special cohort and determine independent prognostic factors. Material/Methods A cohort of Ewing sarcoma patients aged over 40 years from 1973 to 2015 was identified from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan-Meier method and a Cox proportional hazard regression model were used for the prognostic analysis. Results A total of 162 patients were included with a mean age of 53 years. The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the entire group were 43.7% and 47.9%, respectively. The sex, location, tumor size, and radiation treatment had no effect on survival outcomes on univariate analysis. Tumor stage, surgery, and chemotherapy were significant indicators of both OS and CSS on multivariable analysis. Conclusions Surgery in combination with chemotherapy had a significant survival benefit in elderly Ewing sarcoma patients and should be recommended.
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Affiliation(s)
- Hua-Fei Liu
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).,Department of Orthopaedics, Zhejiang Quhua Hospital, Quzhou, Zhejiang, China (mainland)
| | - Ji-Xin Wang
- Department of Orthopedics, Zhejiang Quhua Hospital, Quzhou, Zhejiang, China (mainland)
| | - Dong-Quan Zhang
- Department of Orthopedics, Zhejiang Quhua Hospital, Quzhou, Zhejiang, China (mainland)
| | - Si-Heng Lan
- Department of Orthopedics, Zhejiang Quhua Hospital, Quzhou, Zhejiang, China (mainland)
| | - Qi-Xin Chen
- Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland)
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13
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Nagano A, Ishimaru D, Nishimoto Y, Akiyama H, Kawai A. Primary bone sarcomas in patients over 40 years of age: A retrospective study using data from the Bone Tumor Registry of Japan. J Orthop Sci 2017; 22:749-754. [PMID: 28412026 DOI: 10.1016/j.jos.2017.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/16/2017] [Accepted: 03/14/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Optimal treatments of patients aged >40 years with osteosarcoma and Ewing sarcoma and of patients with other types of bone sarcoma have not yet been established. METHODS The clinical characteristics of 746 patients with primary bone sarcomas aged >40 years listed in the nationwide tumor registry (Bone and Soft Tissue Tumor Registry of Japan) were investigated. Patients with Ewing sarcoma, conventional chondrosarcoma, multiple myeloma, and malignant lymphoma were excluded. The effects of adjuvant chemotherapy were determined by comparing outcomes in patients aged 40-70 years with non-metastatic high grade bone tumors who received surgery plus chemotherapy with those who underwent surgery alone. RESULTS Axial site tumors (38.6%) and distant metastasis at presentation (21.4%) were frequent in patients aged >40 years with primary bone sarcomas. Chemotherapy was administered to 407 (54.6%) patients. Their 5-year overall survival (OS) and progression free survival (PFS) rates were 47.6% and 39.8%, respectively. Multivariate analysis showed that distant metastases at presentation, histological high grade, and radiation therapy were significantly correlated with both OS and PFS. Age and tumor size were also significantly correlated with OS. Patients aged 40-70 years who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year OS rates of 69.3% and 63.2%, respectively (p = 0.092), and 5-year PFS rates of 55.4% and 50.7%, respectively (p = 0.63). CONCLUSIONS Bone sarcoma patients aged >40 years had distinct clinical features and a poor prognosis. Chemotherapy did not improve OS or PFS in patients aged 40-70 years.
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Affiliation(s)
- Akihito Nagano
- The Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan.
| | - Daichi Ishimaru
- The Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Yutaka Nishimoto
- The Department of Nursing Course, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Haruhiko Akiyama
- The Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Akira Kawai
- The Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Ozkurt B, Basarir K, Yalcin B, Merter A, Yildiz Y, Saglik Y. Chemotherapy in primary osteogenic sarcoma in patients over the age of forty. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:123-127. [PMID: 28214261 PMCID: PMC6197300 DOI: 10.1016/j.aott.2016.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/30/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In this study, we sought to review the clinical and histopathological features and the chemotherapy regimens in osteogenic sarcoma in patients over 40 years of age, and we aimed at identifying the possible prognostic factors in this particular group of patients. METHODS We reviewed 287 patients with osteosarcoma treated between the year 1986 and 2010. Patients from this group who met the following criteria were considered eligible for our study; presence of primary OS, had typical histological and radiographic features of OS, no prior history of cancer or any treatment elsewhere and no prior history of preexisting bone abnormalities. RESULTS The Kaplan-Meier survival curve for the entire group, with a 95% confidence interval, at two and five years showed the survival rates as 76.2% and 72.8% respectively. The surgical margin was a significant factor affecting the survival. Presence of a pathological fracture also had a significant effect on the survival rate. CONCLUSION Osteogenic sarcoma remains a challenging disease to treat. Despite the expectation that elderly patients may not tolerate aggressive modern chemotherapy as the younger patients, we believe that patients with primary OS over the age of 40 should be treated aggressively with effective chemotherapy and complete surgical excision whenever possible. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Bulent Ozkurt
- Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Kerem Basarir
- Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey
| | - Bulent Yalcin
- Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Oncology, Ankara, Turkey
| | | | - Yusuf Yildiz
- Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey
| | - Yener Saglik
- Ankara University, School of Medicine, Ibn-i Sina Hospital, Department of Orthopedics, Oncology Section, Ankara, Turkey
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15
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Liu Y, Feng X, Zhang Y, Jiang H, Cai X, Yan X, Huang Z, Mo F, Yang W, Yang C, Yang S, Liu X. Establishment and characterization of a novel osteosarcoma cell line: CHOS. J Orthop Res 2016; 34:2116-2125. [PMID: 27017908 DOI: 10.1002/jor.23245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/23/2016] [Indexed: 02/04/2023]
Abstract
Osteosarcoma has a well-recognized bimodal distribution, with the first peak in adolescence and another in the elderly age-group. The elderly patients have different clinical features and a poorer prognosis as compared to adolescents. To better understand the biological features of osteosarcoma in the elderly population, we established a new human osteosarcoma cell line from a 58-year-old man with primary chondroblastic osteosarcoma. After 6 months of continuous culture in vitro for over 50 passages, an immortalized cell line CHOS was established. The cell line was well-characterized by cytogenetic, biomarker, functional, and histological analyses. The CHOS cells exhibited a spindle-shaped morphology and a doubling time of 36 h. Cytogenetic analysis of CHOS cells revealed the loss of chromosome Y and the gain of chromosome 12. Quantitative real-time polymerase chain reaction (RT-PCR), Western blotting and/or immunofluorescence revealed the expression of chondroblastic, mesenchymal and tumor metastasis markers in the CHOS cells. Compared with the osteosarcoma cell line, the CHOS cells were found to be more sensitive to cisplatin and doxorubicin, but were resistant to methotrexate. The cell line was highly tumorigenic and maintained the histological characteristics and invasive nature of the original tumor. Furthermore, on immunohistochemical analysis, the xenografts and metastases were found to co-express collagen II, aggrecan, vimentin and S100A4 that resembled the original tumor cells. Our results indicate, the potential of CHOS cell line to serve as a useful tool for further studies on the molecular biology of osteosarcoma, especially in the elderly patients. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:2116-2125, 2016.
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Affiliation(s)
- Yunlu Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Xiaobo Feng
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Yukun Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Hongyan Jiang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Xianyi Cai
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Xinxin Yan
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Zengfa Huang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Fengbo Mo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Wen Yang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Cao Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Shuhua Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
| | - Xianzhe Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan 430022, China
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16
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Zheng YF, Lin J, Yang HL. Chondroblastic osteosarcoma secondary to fibrosarcoma: A case report and literature review. Oncol Lett 2016; 10:3573-3576. [PMID: 26788171 DOI: 10.3892/ol.2015.3792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 07/16/2015] [Indexed: 11/05/2022] Open
Abstract
Osteosarcoma, which is most common in non-blood systemic tumors, accounts for 20% of primary bone malignancies. Primary osteosarcoma usually occurs in young individuals aged 10-20 years, while secondary osteosarcoma is more common in the elderly. It had been reported that secondary osteosarcoma may be associated with osteofibrous dysplasia, bone infarction, chondrosarcoma or osteogenesis imperfecta. However, osteosarcoma secondary to fibrosarcoma has rarely been reported. The current study presents the rare case of a female with chondroblastic osteosarcoma secondary to fibrosarcoma. The patient was relatively young and suffered from more than one type of cancer. The course of the disease lasted for >20 years. This case study provides general knowledge of osteosarcoma, and discusses its clinical presentation, diagnosis, treatment and prognosis.
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Affiliation(s)
- Yi-Fei Zheng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jun Lin
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Hui-Lin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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17
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Pan X, Yoshida A, Kawai A, Kondo T. Current status of publicly available sarcoma cell lines for use in proteomic studies. Expert Rev Proteomics 2015; 13:227-40. [PMID: 26653594 DOI: 10.1586/14789450.2016.1132166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cell lines are valuable resources for proteomic studies and can be used as tools to verify the significance of proteomic findings. Here, the authors overview the current status of the publicly available sarcoma cell lines. The authors surveyed seven major cell banks and found that the diversity observed in the sarcoma cell banks was largely insufficient; sarcoma cell lines are available for only a limited histological subtype. They also observed a number of issues with the pathological diagnosis of the cell lines, limitations in their behavioral diversity, and various unmet needs. Well characterized cell lines with accurate diagnosis based on modern diagnosis criteria should be available from public cell banks. The authors conclude that additional cell lines, along with detailed genetic and pathological analyses, should be prepared and deposited in order to promote sarcoma-specific proteomic research. The authors focused on sarcoma cell lines, but their discussion can be applied to the other cancers.
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Affiliation(s)
- Xiaoqing Pan
- a Division of Rare Cancer Research , National Cancer Center Research Institute , Tokyo , Japan
| | - Akihiko Yoshida
- b Department of Pathology , National Cancer Center Hospital , Tokyo , Japan
| | - Akira Kawai
- c Division of Musculoskeletal Oncology , National Cancer Center Hospital , Tokyo , Japan
| | - Tadashi Kondo
- a Division of Rare Cancer Research , National Cancer Center Research Institute , Tokyo , Japan
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18
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Righi A, Paioli A, Dei Tos AP, Gambarotti M, Palmerini E, Cesari M, Marchesi E, Donati DM, Picci P, Ferrari S. High-grade focal areas in low-grade central osteosarcoma: high-grade or still low-grade osteosarcoma? Clin Sarcoma Res 2015; 5:23. [PMID: 26524981 PMCID: PMC4627618 DOI: 10.1186/s13569-015-0038-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/27/2015] [Indexed: 11/18/2022] Open
Abstract
Background High-grade foci (grade 3 according to Broder’s grading system) are sometimes detected in low-grade (grade 1 and 2) central osteosarcoma. The aim of this study was to retrospectively evaluate the clinical outcome in patients upgraded to high grade (grade 3) after a first diagnosis of low-grade osteosarcoma, following the detection of high-grade areas (grade 3) in the resected specimen. Methods Of the 132 patients with a diagnosis of low-grade central osteosarcoma at surgical biopsy at our Institute, 33 patients were considered eligible for the study. Results Median age was 37 (range 13–58 years). Location was in an extremity in 29 patients (88 %). Post-operative chemotherapy was given in 22 (67 %) patients. Follow-up data were available for all patients, with a median observation time of 115 months (range 4–322 months). After histological revision, areas of high-grade (grade 3) osteosarcoma accounting for less than 50 % of the tumor were found in 20 (61 %) patients, whereas the majority of the tumor was composed of a high-grade (grade 3) component in 13 (39 %) patients. In the 20 cases of low-grade osteosarcoma with high-grade foci (grade 3) in less than 50 % of the tumor, 9 patients did not receive adjuvant chemotherapy; only one of them died, of unrelated causes. In the adjuvant chemotherapy group (11 out of 20 patients), one patient developed multiple lung metastases and died of disease 39 months after the first diagnosis. In the other 13 cases of low-grade osteosarcoma with high-grade foci (grade 3) in more than 50 % of the tumor, 12 patients received adjuvant chemotherapy: 2 had recurrence, 4 developed multiple lung metastases and 3 died of disease. The only patient who did not receive chemotherapy is alive without disease 232 months after complete surgical remission. Conclusion Our data indicate that patients with a diagnosis of low-grade osteosarcoma where the high-grade (grade 3) component is lower than 50 % of the resected specimen, may not require chemotherapy, achieving high survival rates by means of complete surgical resection only.
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Affiliation(s)
- Alberto Righi
- Department of Pathology, Rizzoli Institute, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - Anna Paioli
- Department of Oncology, Rizzoli Institute, Bologna, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Rizzoli Institute, Via di Barbiano 1/10, 40136 Bologna, Italy ; Department of Pathology, Treviso Regional Hospital, Treviso, Italy
| | - Marco Gambarotti
- Department of Pathology, Rizzoli Institute, Via di Barbiano 1/10, 40136 Bologna, Italy
| | | | - Manuela Cesari
- Department of Oncology, Rizzoli Institute, Bologna, Italy
| | | | | | - Piero Picci
- Department of Pathology, Rizzoli Institute, Via di Barbiano 1/10, 40136 Bologna, Italy
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19
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Joo MW, Shin SH, Kang YK, Kawai A, Kim HS, Asavamongkolkul A, Jeon DG, Kim JD, Niu X, Tsuchiya H, Puri A, Wang EHM, Chung SH, Chung YG. Osteosarcoma in Asian Populations Over the Age of 40 Years: A Multicenter Study. Ann Surg Oncol 2015; 22:3557-64. [PMID: 25676843 DOI: 10.1245/s10434-015-4414-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Elderly patients with osteosarcoma (OSA) are no longer uncommon; however, many questions remain regarding this population. We investigated the clinicopathological characteristics and prognostic factors of OSA in an Asian population over the age of 40 years. METHODS This was a multi-national, multi-institutional study by the Eastern Asian Musculoskeletal Oncology Group (EAMOG). RESULTS A total of 232 patients were enrolled (116 males and 116 females), with a median age of 50 years at diagnosis; 25 (10.8 %) patients exhibited initial metastasis. Median follow-up was 52 months for survivors. We observed 102 osteolytic and mixed radiographic findings for 173 lesions. Histological subtypes other than osteoblastic type were frequent. Radiation-associated OSA was seen in seven patients, with a 5-year overall survival (OS) of 16.7 %. No Paget's OSA was observed. High-grade spinopelvic OSA was seen in 29 (12.5 %) patients. The 5-year OS was 59.4 % in patients without initial metastasis and 45.2 % in patients with spinopelvic OSA. While surgery and initial metastasis were common prognostic factors for OS, chemotherapy was not. Histologic response to neoadjuvant chemotherapy was poor in 61 of 83 patients. CONCLUSION This study revealed distinct clinicopathological features of OSA patients over 40 years of age compared with younger patients, such as the high incidence of axial tumors, common osteolytic and mixed radiographic findings, the high frequency of unusual histologic subtypes, and poor prognosis. Contrary to Western elderly patients with OSA, there was no Paget's OSA in this study, which may result in a lower incidence of secondary OSA. Prognostic factor analyses demonstrated chemotherapy did not influence OS.
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Affiliation(s)
- Min Wook Joo
- Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Seung Han Shin
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Koo Kang
- Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Han Soo Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Apichat Asavamongkolkul
- Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Dae-Geun Jeon
- Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Jae Do Kim
- Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea
| | - Xiaohui Niu
- Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Ajay Puri
- Department of Orthopaedic Oncology, Tata Memorial Hospital, Mumbai, India
| | - Edward H M Wang
- Tumor Service, Department of Orthopedics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - So Hak Chung
- Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea
| | - Yang-Guk Chung
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Urakawa H, Tsukushi S, Sugiura H, Yamada K, Yamada Y, Kozawa E, Arai E, Futamura N, Ishiguro N, Nishida Y. Neoadjuvant and adjuvant chemotherapy with doxorubicin and ifosfamide for bone sarcomas in adult and older patients. Oncol Lett 2014; 8:2485-2488. [PMID: 25364412 PMCID: PMC4214507 DOI: 10.3892/ol.2014.2567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 09/08/2014] [Indexed: 12/11/2022] Open
Abstract
The present study investigated the safety and efficacy of neoadjuvant and adjuvant chemotherapy with doxorubicin and ifosfamide for bone sarcoma in adult and older patients. A total of 18 consecutive patients with bone sarcoma (American Joint Committee on Cancer stage II in 14 patients and stage IV in four) treated with neoadjuvant and adjuvant chemotherapy at Nagoya Musculoskeletal Oncology Group hospitals in Japan between 2004 and 2011 were reviewed. The treatment efficacy and side-effects were evaluated. The responses to neoadjuvant chemotherapy were stable disease in 11 patients and progressive disease in three. Among the 12 evaluable patients, there were five with ≥90% tumor necrosis. The estimated overall survival (OS) rate at five years for the patients without metastasis prior to treatment was 56%. Major grade 3 or 4 side-effects included leukopenia in 14 cases, anemia in seven, thrombocytopenia in three, nausea in two and febrile neutropenia in two. One patient discontinued chemotherapy due to a temporarily depressed level of consciousness with arrhythmia (grade 2). The estimated five-year OS rate in this study was acceptable in patients without metastasis prior to treatment. A better coordinated prospective study of this combination regimen for older patients with bone sarcoma will be required to clarify its efficacy and tolerability.
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Affiliation(s)
- Hiroshi Urakawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Satoshi Tsukushi
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Hideshi Sugiura
- Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Kenji Yamada
- Orthopedic Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Aichi 444-0011, Japan
| | - Yoshihisa Yamada
- Orthopedic Surgery, Nagoya Memorial Hospital, Nagoya, Aichi 468-8520, Japan
| | - Eiji Kozawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Eisuke Arai
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Naohisa Futamura
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Aichi 466-8550, Japan
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Choi LE, Healey JH, Kuk D, Brennan MF. Analysis of outcomes in extraskeletal osteosarcoma: a review of fifty-three cases. J Bone Joint Surg Am 2014; 96:e2. [PMID: 24382730 PMCID: PMC6948789 DOI: 10.2106/jbjs.m.00339] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Extraskeletal osteosarcoma is a rare soft-tissue sarcoma about which little is known. The objectives of this study were to describe the clinical features and natural history of extraskeletal osteosarcoma and to investigate factors affecting outcomes. METHODS A retrospective review of a prospectively maintained database of patients diagnosed with soft-tissue sarcoma was conducted. Patients with pathologically confirmed extraskeletal osteosarcoma from 1982 to 2012 were identified and were included in the analysis. Medical records were reviewed for clinical features, treatment, and outcomes. RESULTS Fifty-three patients were identified from the database: forty-two presented with localized disease, two presented with metastatic disease, and nine presented with recurrent (local and/or distant) disease. The median patient age at diagnosis was sixty-four years, with a median follow-up time of thirty-four months (range, one to 290 months) for survivors. Of the fifty-three patients who were identified, forty-one had lesions in the extremities, fifty-one had high-grade lesions, forty had lesions >5 cm, and forty-two had deep lesions. For patients presenting with localized disease, the median survival was 45.8 months with a three-year cumulative incidence of death due to disease of 39%. All patients with localized disease were managed with surgical resection of the primary tumor: nineteen with surgery only, ten with adjuvant radiation, five with adjuvant chemotherapy, and eight with both radiation and chemotherapy. Eighteen patients relapsed: two patients had local recurrences, ten patients had distant metastases, and six patients had local recurrences and distant metastases. In log-rank analysis, patients with superficial tumors and negative margins at resection had a higher three-year event-free survival. No significant association of disease-specific or event-free survival was found with the addition of radiation, chemotherapy, or both to surgery. CONCLUSIONS For patients presenting with localized extraskeletal osteosarcoma, three-year event-free survival was higher for patients with superficial tumors and negative margins at resection. Radiation and chemotherapeutic treatment were not associated with a lower incidence of death due to disease or a longer event-free survival.
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Affiliation(s)
- Lisa E. Choi
- Orthopaedic Surgery Service (L.E.C. and J.H.H.), Gastric and Mixed Tumor Service (M.F.B.), Department of Surgery, and Department of Epidemiology and Biostatistics (D.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. E-mail address for J.H. Healey:
| | - John H. Healey
- Orthopaedic Surgery Service (L.E.C. and J.H.H.), Gastric and Mixed Tumor Service (M.F.B.), Department of Surgery, and Department of Epidemiology and Biostatistics (D.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. E-mail address for J.H. Healey:
| | - Deborah Kuk
- Orthopaedic Surgery Service (L.E.C. and J.H.H.), Gastric and Mixed Tumor Service (M.F.B.), Department of Surgery, and Department of Epidemiology and Biostatistics (D.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. E-mail address for J.H. Healey:
| | - Murray F. Brennan
- Orthopaedic Surgery Service (L.E.C. and J.H.H.), Gastric and Mixed Tumor Service (M.F.B.), Department of Surgery, and Department of Epidemiology and Biostatistics (D.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. E-mail address for J.H. Healey:
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Jeon DG, Kong CB, Cho WH, Song WS, Cho SH, Choi SW, Lee SY. Examination of the cutoff value of postchemotherapy increase in tumor volume as a predictor of subsequent oncologic events in stage IIB osteosarcoma. J Surg Oncol 2013; 109:275-9. [DOI: 10.1002/jso.23496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/17/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Dae-Geun Jeon
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Chang-Bae Kong
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Wan Hyeong Cho
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Won Seok Song
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Sang Hyun Cho
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Sung Woo Choi
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Soo-Yong Lee
- Department of Orthopedic Surgery; Korea Cancer Center Hospital; Seoul Korea
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Iwata S, Ishii T, Kawai A, Hiruma T, Yonemoto T, Kamoda H, Asano N, Takeyama M. Prognostic Factors in Elderly Osteosarcoma Patients: A Multi-institutional Retrospective Study of 86 Cases. Ann Surg Oncol 2013; 21:263-8. [DOI: 10.1245/s10434-013-3210-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Indexed: 11/18/2022]
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Bischel OE, Böhm PM. The use of a femoral revision stem in the treatment of primary or secondary bone tumours of the proximal femur. ACTA ACUST UNITED AC 2010; 92:1435-41. [DOI: 10.1302/0301-620x.92b10.24024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Endoprosthetic reconstruction following resection of 31 tumours of the proximal femur in 30 patients was performed using a Wagner SL femoral revision stem. The mean follow-up was 25.6 months (0.6 to 130.0). Of the 28 patients with a metastasis, 27 died within a mean follow-up period of 18.1 months (0.6 to 56.3) after the operation, and the remaining patient was excluded from the study 44.4 months post-operatively when the stem was removed. The two patients with primary bone tumours were still alive at the latest follow-up of 81.0 and 130.0 months, respectively. One stem only was removed for suspected low-grade infection 44.4 months post-operatively. The worst-case survival rate with removal of the stem for any cause and/or loss to follow-up was 80.0% (95% confidence interval 44.9 to 100) at 130.0 months. The mean Karnofsky index increased from 44.2% (20% to 70%) pre-operatively to 59.7% (0% to 100%) post-operatively, and the mean Merle d’Aubigné score improved from 4.5 (0 to 15) to 12.0 (0 to 18). The mean post-operative Musculoskeletal Tumour Society score was 62.4% (3.3% to 100%). The Wagner SL femoral revision stem offers an alternative to special tumour prostheses for the treatment of primary and secondary tumours of the proximal femur. The mid-term results are very promising, but long-term experience is necessary.
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Affiliation(s)
- O. E. Bischel
- Orthopaedic University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany
| | - P. M. Böhm
- Zentrum für Orthopädie High-Tech-Clinic, Neumeyerstrasse 46, 90411 Nürnberg, Germany
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Song W, Kong CB, Jeon DG, Cho W, Kim M, Lee J, Yoo J, Kim J, Lee SY. Prognosis of extremity osteosarcoma in patients aged 40–60 years: A cohort/case controlled study at a single institute. Eur J Surg Oncol 2010; 36:483-8. [DOI: 10.1016/j.ejso.2010.03.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 02/13/2010] [Accepted: 03/15/2010] [Indexed: 11/24/2022] Open
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Health related quality of life assessment in metastatic disease of the spine: a systematic review. Spine (Phila Pa 1976) 2009; 34:S128-34. [PMID: 19829272 DOI: 10.1097/brs.0b013e3181b778b2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic literature review. OBJECTIVES To examine the available literature on health related quality of life (HRQOL) assessment in metastatic disease of the spine and identify the optimal functional outcome scales to be used in developing a disease-specific tool. SUMMARY OF BACKGROUND DATA There is a lack of consensus in the use of HRQOL measures in patients with metastatic spine disease. METHODS A systematic review was conducted using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature, the PsycINFO, the Allied and Complementary Medicine (AMED), Cochrane Reviews and Global Health databases for clinical studies addressing metastatic spine disease from 1966 through 2008. The validity of outcome tools was established by linkage analysis with the International Classification of Functioning Disability and Health (ICF). RESULTS One hundred forty-one clinical studies met inclusion criteria including 10,347 patients. Only 5 moderate grade and 1 high grade study were identified. Thirty- four studies used a patient self-assessment instrument to assess health status. None of the instruments were validated for metastatic spine patients. The most commonly used Pi-by-no tools were SF-36, SIP 5, and the ADL. None of the studies defined health related quality of life (HRQOL) or justified the choice of instrument. The most commonly used cancer-specific tools were ECOG, EORTC QCQ-C30, and EUROQOL 5D. Based on frequency of citation and on correlation with the International Classification of Functioning Disability and Health, the ECOG and SF36 were judged as most valid and reliable. CONCLUSION A systematic review of the available evidence suggests that valid and reliable health related quality of life measures exist for the assessment of oncology patients; however, a disease-specific tool for metastatic spine disease awaits development. Until such time as a disease-specific tool is available, we recommend that the ECOG and SF-36 be considered for use in studies addressing the outcome assessment of patients with metastatic spine disease.
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Nishida Y, Isu K, Ueda T, Nishimoto Y, Tsuchiya H, Wada T, Sato K, Tsukushi S, Sugiura H. Osteosarcoma in the elderly over 60 years: a multicenter study by the Japanese Musculoskeletal Oncology Group. J Surg Oncol 2009; 100:48-54. [PMID: 19384906 DOI: 10.1002/jso.21287] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have described the characteristics and prognostic factors of osteosarcoma patients aged over 60 years. METHODS The Japanese Musculoskeletal Oncology Group (JMOG) carried out a retrospective review of patients over the age of 60 years with osteosarcoma. RESULTS Only 12 patients had secondary osteosarcoma, with none associated with Paget's disease. The primary disease sites were the extremities in 63% and trunk in 33%. The overall survival was 42.8% and disease-free survival was 40.8% at 5 years in the high grade group. An univariate analysis indicated that significant poor prognostic factors for overall survival were axial location, lung metastasis at initial presentation, and absence of surgical treatment. Multivariate analysis revealed that a significant poor prognostic factor for overall survival was the absence of surgical treatment. Secondary osteosarcoma did not lower the overall or the disease-free survival in any group. CONCLUSIONS The current study indicates that the number of osteosarcoma patients over 60 years is increasing. The number of cases with secondary osteosarcoma over 60 years is relatively small in Japan, with no patients having osteosarcomas related to Paget's disease. Although there is a predilection for axial localization, surgical treatment has a significant impact on patient's prognosis.
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Affiliation(s)
- Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Schwab JH, Antonescu CR, Athanasian EA, Boland PJ, Healey JH, Morris CD. A comparison of intramedullary and juxtacortical low-grade osteogenic sarcoma. Clin Orthop Relat Res 2008; 466:1318-22. [PMID: 18425560 PMCID: PMC2384019 DOI: 10.1007/s11999-008-0251-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 03/28/2008] [Indexed: 01/31/2023]
Abstract
UNLABELLED While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities. We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of local recurrence, grade progression, and survival between low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma. Forty-five (76%) patients were treated for low-grade juxtacortical osteogenic sarcoma and 14 (24%) were treated for low-grade intramedullary osteogenic sarcoma. Local recurrence rates of 7% were similar for both groups studied. The rate of distant metastases was also similar for both groups. . The rate of dedifferentiation for the entire group was 29%. Dedifferentiated lesions were treated with adjuvant chemotherapy in 16 of 17 cases. Recurrence preceded dedifferentiation in four cases. Five-year survival was over 90% in both groups. Low-grade intramedullary and low-grade juxtacortical osteogenic sarcoma were clinically indistinguishable with identical rates of local recurrence, distant metastases, dedifferentiation, and survival. LEVEL OF EVIDENCE Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Joseph H. Schwab
- />Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021 USA
| | - Cristina R. Antonescu
- />Department of Pathology, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, New York, NY USA
| | - Edward A. Athanasian
- />Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021 USA
| | - Patrick J. Boland
- />Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021 USA
| | - John H. Healey
- />Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021 USA
| | - Carol D. Morris
- />Department of Surgery/Section of Orthopedics, Memorial Sloan Kettering Cancer, Weill Cornell Medical School, 1275 York Avenue, New York, NY 10021 USA
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Occult thyroid carcinoma detected by FDG-PET scan in elderly osteosarcoma patients: report of two cases. Ann Nucl Med 2007; 21:529-32. [DOI: 10.1007/s12149-007-0058-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 07/23/2007] [Indexed: 10/22/2022]
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