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Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols.
J Clin Oncol. 2003 May 15; 21(10):2011-8.JC

Abstract

PURPOSE

To determine demographic data and define prognostic factors for long-term outcome in patients presenting with high-grade osteosarcoma of bone with clinically detectable metastases at initial presentation.

PATIENTS AND METHODS

Of 1,765 patients with newly diagnosed, previously untreated high-grade osteosarcomas of bone registered in the neoadjuvant Cooperative Osteosarcoma Study Group studies before 1999, 202 patients (11.4%) had proven metastases at diagnosis and therefore were enrolled onto an analysis of demographic-, tumor-, and treatment-related variables, response, and survival. The intended therapeutic strategy included pre- and postoperative multiagent chemotherapy as well as aggressive surgery of all resectable lesions.

RESULTS

With a median follow-up of 1.9 years (5.5 years for survivors), 60 patients were alive, 37 of whom were in continuously complete surgical remission. Actuarial overall survival rates at 5 and 10 (same value for 15) years were 29% (SE = 3%) and 24% (SE = 4%), respectively. In univariate analysis, survival was significantly correlated with patient age, site of the primary tumor, number and location of metastases, number of involved organ systems, histologic response of the primary tumor to preoperative chemotherapy, and completeness and time point of surgical resection of all tumor sites. However, after multivariate Cox regression analysis, only multiple metastases at diagnosis (relative hazard rate [RHR] = 2.3) and macroscopically incomplete surgical resection (RHR = 2.4) remained significantly associated with inferior outcomes.

CONCLUSION

The number of metastases at diagnosis and the completeness of surgical resection of all clinically detected tumor sites are of independent prognostic value in patients with proven primary metastatic osteosarcoma.

Authors+Show Affiliations

Cooperative German-Austrian-Swiss Osteosarcoma Study Center, Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Albert-Schweitzer Str 33, 48129 Muenster, Germany; coss@uni-muenster.de.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12743156

Citation

Kager, Leo, et al. "Primary Metastatic Osteosarcoma: Presentation and Outcome of Patients Treated On Neoadjuvant Cooperative Osteosarcoma Study Group Protocols." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 21, no. 10, 2003, pp. 2011-8.
Kager L, Zoubek A, Pötschger U, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol. 2003;21(10):2011-8.
Kager, L., Zoubek, A., Pötschger, U., Kastner, U., Flege, S., Kempf-Bielack, B., Branscheid, D., Kotz, R., Salzer-Kuntschik, M., Winkelmann, W., Jundt, G., Kabisch, H., Reichardt, P., Jürgens, H., Gadner, H., & Bielack, S. S. (2003). Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 21(10), 2011-8.
Kager L, et al. Primary Metastatic Osteosarcoma: Presentation and Outcome of Patients Treated On Neoadjuvant Cooperative Osteosarcoma Study Group Protocols. J Clin Oncol. 2003 May 15;21(10):2011-8. PubMed PMID: 12743156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. AU - Kager,Leo, AU - Zoubek,Andreas, AU - Pötschger,Ulrike, AU - Kastner,Ulrike, AU - Flege,Silke, AU - Kempf-Bielack,Beate, AU - Branscheid,Detlev, AU - Kotz,Rainer, AU - Salzer-Kuntschik,Mechthild, AU - Winkelmann,Winfried, AU - Jundt,Gernot, AU - Kabisch,Hartmut, AU - Reichardt,Peter, AU - Jürgens,Heribert, AU - Gadner,Helmut, AU - Bielack,Stefan S, AU - ,, PY - 2003/5/14/pubmed PY - 2003/5/28/medline PY - 2003/5/14/entrez SP - 2011 EP - 8 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 21 IS - 10 N2 - PURPOSE: To determine demographic data and define prognostic factors for long-term outcome in patients presenting with high-grade osteosarcoma of bone with clinically detectable metastases at initial presentation. PATIENTS AND METHODS: Of 1,765 patients with newly diagnosed, previously untreated high-grade osteosarcomas of bone registered in the neoadjuvant Cooperative Osteosarcoma Study Group studies before 1999, 202 patients (11.4%) had proven metastases at diagnosis and therefore were enrolled onto an analysis of demographic-, tumor-, and treatment-related variables, response, and survival. The intended therapeutic strategy included pre- and postoperative multiagent chemotherapy as well as aggressive surgery of all resectable lesions. RESULTS: With a median follow-up of 1.9 years (5.5 years for survivors), 60 patients were alive, 37 of whom were in continuously complete surgical remission. Actuarial overall survival rates at 5 and 10 (same value for 15) years were 29% (SE = 3%) and 24% (SE = 4%), respectively. In univariate analysis, survival was significantly correlated with patient age, site of the primary tumor, number and location of metastases, number of involved organ systems, histologic response of the primary tumor to preoperative chemotherapy, and completeness and time point of surgical resection of all tumor sites. However, after multivariate Cox regression analysis, only multiple metastases at diagnosis (relative hazard rate [RHR] = 2.3) and macroscopically incomplete surgical resection (RHR = 2.4) remained significantly associated with inferior outcomes. CONCLUSION: The number of metastases at diagnosis and the completeness of surgical resection of all clinically detected tumor sites are of independent prognostic value in patients with proven primary metastatic osteosarcoma. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/12743156/Primary_metastatic_osteosarcoma:_presentation_and_outcome_of_patients_treated_on_neoadjuvant_Cooperative_Osteosarcoma_Study_Group_protocols_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2003.08.132?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -