Solitary pulmonary metastases at first recurrence of osteosarcoma: presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group
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 t...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
September 2023
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| In: |
Cancer medicine
Year: 2023, Volume: 12, Issue: 17, Pages: 18219-18234 |
| ISSN: | 2045-7634 |
| DOI: | 10.1002/cam4.6409 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1002/cam4.6409 Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/cam4.6409 
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| Author Notes: | Vanessa L. Mettmann, Daniel Baumhoer, Stefan S. Bielack, Claudia Blattmann, Godehard Friedel, Thekla von Kalle, Leo Kager, Matthias Kevric, Michaela Nathrath, Benjamin Sorg, Matthias Dürken, Stefanie Hecker-Nolting |
| Summary: | 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. |
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| Item Description: | Online veröffentlicht: 7. August 2023 Gesehen am 01.08.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2045-7634 |
| DOI: | 10.1002/cam4.6409 |