Treatment of osteosarcoma at first recurrence after contemporary therapy: The Memorial Sloan-Kettering Cancer Center experience Journal Article
| Authors: | Chou, A. J.; Merola, P. R.; Wexler, L. H.; Gorlick, R. G.; Vyas, Y. M.; Healey, J. H.; LaQuaglia, M. P.; Huvos, A. G.; Meyers, P. A. |
| Article Title: | Treatment of osteosarcoma at first recurrence after contemporary therapy: The Memorial Sloan-Kettering Cancer Center experience |
| Abstract: | BACKGROUND. Overall survival after recurrence of osteosarcoma (OS) is < 30%. The authors reported their experience treating recurrent OS at the time of first recurrence (R1). METHODS. Patients with high-grade OS who achieved complete disease remission (CR) after primary surgery and chemotherapy, and patients who were treated at R1 at Memorial Sloan-Kettering Cancer Center (New York, NY) after 1990 were analyzed by retrospective chart review. RESULTS. For 43 eligible patients, the median time to R1 from initial diagnosis was 21.7 months (range, 4.6-135.7 mos). The lungs were the most common sites of disease recurrence (n = 33 of 43). With a median follow-up of 15.2 months (range, 0.7-158.3 mos) after R1, 15 of 43 (35%) patients were alive. Four of 43 patients were treated with surgery alone (3 patients were alive and 1 had died of progressive disease at the time of last follow-up). Due to unresectable disease, eight patients received only chemotherapy, none of whom survived. For patients with disease recurrence treated with chemotherapy and surgery (n = 31), 22 patients achieved a second CR (CR2). Nine patients were alive and in disease remission (29%) at the time of last follow-up. Twenty-three patients received ifosfamide as part of their retrieval regimen. Of the 18 who achieved a CR2, 8 experienced disease recurrence, 7 remain alive in CR2, and 3 died due to toxicity. Eight patients did not receive ifosfamide. Of these,'4 achieved a CR2 but 3 subsequently experienced disease recurrence. CONCLUSIONS. At R1, 22 of 31 patients achieved a CR2 with aggressive surgery and chemotherapy. The majority of these patients subsequently developed a disease recurrence. Patients appeared to benefit from the addition of ifosfamide to their retrieval regimens. In the end, the role of chemotherapy in recurrent OS continues to remain undefined. Cancer 2005;104:2214-21. copy; 2005 American Cancer Society. |
| Keywords: | osteosarcoma; adolescent; adult; cancer chemotherapy; cancer survival; child; clinical article; preschool child; school child; treatment outcome; bone neoplasms; child, preschool; survival analysis; cancer surgery; retrospective studies; review; cancer recurrence; cisplatin; doxorubicin; united states; chemotherapy; treatment; methotrexate; topotecan; drug megadose; follow up; cancer grading; neoplasm recurrence, local; etoposide; antineoplastic combined chemotherapy protocols; recurrence; cyclophosphamide; vincristine; ifosfamide; irinotecan; cause of death; lung metastasis; cancer regression; dactinomycin; bleomycin; surgery; trabectedin; orthopedic procedures; trimetrexate; n acetylmuramylalanyl dextro isoglutaminylalanyl dipalmitoylphosphatidylethanolamine |
| Journal Title: | Cancer |
| Volume: | 104 |
| Issue: | 10 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2005-11-15 |
| Start Page: | 2214 |
| End Page: | 2221 |
| Language: | English |
| DOI: | 10.1002/cncr.21417 |
| PUBMED: | 16206297 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 43" - "Export Date: 24 October 2012" - "CODEN: CANCA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work