Recurrent osteosarcoma with a single pulmonary metastasis: A multi-institutional review Journal Article


Authors: Daw, N. C.; Chou, A. J.; Jaffe, N.; Rao, B. N.; Billups, C. A.; Rodriguez-Galindo, C.; Meyers, P. A.; Huh, W. W.
Article Title: Recurrent osteosarcoma with a single pulmonary metastasis: A multi-institutional review
Abstract: Background: Late relapse and solitary lesion are positive prognostic factors in recurrent osteosarcoma. Methods: We reviewed the records of 39 patients treated at three major centres for recurrent osteosarcoma with a single pulmonary metastasis more than 1 year after diagnosis. We analysed their outcomes with respect to clinical factors and treatment with chemotherapy. Results: Median age at diagnosis was 14.6 years. Relapse occurred at a median of 2.5 years (range, 1.2-8.2 years) after initial diagnosis. At relapse, all patients were treated by metastasectomy; 12 (31%) patients also received chemotherapy. There was no difference in time to recurrence or nodule size between the patients who received or did not receive chemotherapy at relapse. Sixteen patients had no subsequent recurrence, 13 of whom survive without evidence of disease. The 5-year and 10-year estimates of post-relapse event-free survival (PREFS) were 33.0±7.5% and 33.0±9.6%, respectively, and of post-relapse survival (PRS) 56.8±8.6% and 53.0±11.0%, respectively. There was a trend for nodules <1.5 cm to correlate positively with PREFS (P = 0.070) but not PRS (P = 0.49). Chemotherapy at first relapse was not associated with PREFS or PRS. Conclusion: Approximately half of the patients with recurrent osteosarcoma presenting as a single pulmonary metastasis more than 1 year after diagnosis were long-term survivors. Metastasectomy was the primary treatment; chemotherapy did not add benefit.
Keywords: osteosarcoma; adolescent; adult; cancer chemotherapy; cancer survival; child; clinical article; event free survival; treatment outcome; cancer surgery; cancer recurrence; cancer growth; chemotherapy; outcome assessment; follow up; antineoplastic agent; thoracotomy; recurrence; lung metastasis; lung; metastasectomy; predictive value; metastasis resection; nodule; cancer prognosis; human; male; female; priority journal; article; solitary; post relapse event free survival; post relapse survival
Journal Title: British Journal of Cancer
Volume: 112
Issue: 2
ISSN: 0007-0920
Publisher: Nature Publishing Group  
Date Published: 2015-01-20
Start Page: 278
End Page: 282
Language: English
DOI: 10.1038/bjc.2014.585
PROVIDER: scopus
PUBMED: 25422914
PMCID: PMC4453448
DOI/URL:
Notes: Export Date: 2 March 2015 -- Source: Scopus
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  1. Alexander Ja-Ho Chou
    58 Chou
  2. Paul Meyers
    311 Meyers