Osteogenic sarcoma with clinically detectable metastasis at initial presentation Journal Article
| Authors: | Meyers, P. A.; Heller, G.; Healey, J. H.; Huvos, A.; Applewhite, A.; Sun, M.; LaQuaglia, M. |
| Article Title: | Osteogenic sarcoma with clinically detectable metastasis at initial presentation |
| Abstract: | Purpose: Chemotherapy and surgery have improved the length of survival for patients with osteogenic sarcoma (OS) who present without metastatic disease. We reviewed our experience with patients with OS who presented with clinically detectable metastasis to determine the prognostic factors and the effects of surgery on the primary tumor and on metastatic disease. Patients and Methods: From 1975 to 1984 we treated 62 patients who had previously untreated OS with metastasis detected at presentation. All of these patients received intensive chemotherapy that included high-dose methotrexate; doxorubicin; and bleomycin, cyclophosphamide, and dactinomycin (BCD). Selected patients also received cisplatin. The intent of surgery was resection of the primary tumor and metastatic disease. Results: Survival was extremely poor; only 11% of patients survived, with a median survival of 20 months. Survival was not affected by use of preoperative che- motherapy versus immediate surgery, and did not correlate with serum lactate dehydrogenase (LDH) level, alkaline phosphatase level, or the site of the primary tumor. Survival did correlate with age, location of metastatic disease, histologic response to preoperative chemotherapy, and completeness of surgical resection of all sites of tumor. Resection of all sites of tumor identified at initial presentation was necessary for survival. Conclusion: OS that presents with metastatic disease has a very poor prognosis with therapy, although therapy has achieved good results for patients without metastasis detected at diagnosis. Aggressive surgical resection of tumor is necessary for survival. The use of novel therapies at initial presentation is justified with this group of patients. © 1993 by American Society of Clinical Oncology. |
| Keywords: | osteosarcoma; adolescent; adult; cancer survival; child; treatment outcome; survival analysis; cancer surgery; retrospective studies; major clinical study; cancer localization; cisplatin; doxorubicin; cancer combination chemotherapy; bone metastasis; combined modality therapy; methotrexate; metastasis; antineoplastic combined chemotherapy protocols; cyclophosphamide; alkaline phosphatase; lung metastasis; infant; dactinomycin; bleomycin; lactate dehydrogenase; alkaline phosphatase blood level; lactate dehydrogenase blood level; prognosis; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 11 |
| Issue: | 3 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1993-03-01 |
| Start Page: | 449 |
| End Page: | 453 |
| Language: | English |
| DOI: | 10.1200/jco.1993.11.3.449 |
| PUBMED: | 8445419 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2019 -- Source: Scopus |
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