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- Title
Solitary pulmonary metastases at first recurrence of osteosarcoma: Presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group.
- Authors
Mettmann, Vanessa L.; Baumhoer, Daniel; Bielack, Stefan S.; Blattmann, Claudia; Friedel, Godehard; von Kalle, Thekla; Kager, Leo; Kevric, Matthias; Nathrath, Michaela; Sorg, Benjamin; Dürken, Matthias; Hecker‐Nolting, Stefanie
- Abstract
Background: To evaluate patient and tumour characteristics, treatment and their impact on survival in patients with a solitary pulmonary metastasis at first relapse of high‐grade osteosarcoma. Procedure: Two‐hundred and nineteen consecutive patients who had achieved a complete surgical remission and then developed a solitary pulmonary metastasis at first recurrence of high‐grade osteosarcoma were retrospectively reviewed. Results: Two hundred and three (94.9%) of 214 patients achieved a second complete remission. After a median time from initial diagnosis of osteosarcoma to first relapse of 2.3 years (range, 0.3–18.8 years), actuarial post‐relapse overall survival after 2 and 5 years was 72.0% and 51.2%. Post‐relapse event‐free survival was 39.1% and 31.1%. Median follow‐up time was 3.2 years (range, 0.1–29.4 years). A longer time until first relapse and diagnosis due to imaging were positive prognostic factors in uni‐ and multivariate analyses, as were a second complete surgical remission and, in regard to death, the absence of a subsequent relapse. The use of salvage chemotherapy and radiotherapy were not associated with patient outcomes, nor was the surgical approach (thoracoscopy vs. thoracotomy) nor the exploration (uni‐ vs. bilateral). Conclusion: Approximately half of the patients who experience a solitary pulmonary relapse at first recurrence of osteosarcoma remain alive 5 years after this first relapse. Only one third will remain disease‐free. A complete surgical resection of the lesion is essential for long‐term survival while relapse chemotherapy does not seem to improve survival. Innovative therapies are required to improve outcomes.
- Subjects
OVERALL survival; OSTEOSARCOMA; CANCER relapse; PROGNOSIS; SURGICAL excision; SOLITARY pulmonary nodule
- Publication
Cancer Medicine, 2023, Vol 12, Issue 17, p18219
- ISSN
2045-7634
- Publication type
Article
- DOI
10.1002/cam4.6409