Comment on “Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols”

2002 ◽  
Vol 20 (12) ◽  
pp. 2910-2911 ◽  
Author(s):  
Stefano Ferrari ◽  
Mario Mercuri ◽  
Gaetano Bacci ◽  
Stefan S. Bielack ◽  
Heribert Jürgens
Keyword(s):  
Prognostic Factors ◽  
Study Group ◽  
High Grade ◽  
High Grade Osteosarcoma

Prognostic Factors in High-Grade Osteosarcoma of the Extremities or Trunk: An Analysis of 1,702 Patients Treated on Neoadjuvant Cooperative Osteosarcoma Study Group Protocols

2002 ◽  
Vol 20 (3) ◽  
pp. 776-790 ◽  
Author(s):  
Stefan S. Bielack ◽  
Beate Kempf-Bielack ◽  
Günter Delling ◽  
G. Ulrich Exner ◽  
Silke Flege ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Wide Spectrum ◽  
Survival Rates ◽  
Study Group ◽  
High Grade ◽  
Tumor Site ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Response To Chemotherapy ◽  
High Grade Osteosarcoma

PURPOSE: To define prognostic factors for response and long-term outcome for a wide spectrum of osteosarcomas, extending well beyond those of the typical young patient with seemingly localized extremity disease. PATIENTS AND METHODS: A total of 1,702 consecutive newly diagnosed patients with high-grade osteosarcoma of the trunk or limbs registered into the neoadjuvant studies of the Cooperative Osteosarcoma Study Group before July 1998 were entered into an analysis of demographic, tumor-related, and treatment-related variables, response, and survival. The intended therapeutic strategy included preoperative and postoperative chemotherapy with multiple agents as well as surgery of all operable lesions. RESULTS: Axial tumor site, male sex, and a long history of symptoms were associated with poor response to chemotherapy in univariate and multivariate analysis. Actuarial 10-year overall and event-free survival rates were 59.8% and 48.9%. Among the variables assessable at diagnosis, patient age (actuarial 10-year survival ≥ 40, 41.6%; < 40, 60.2%; P = .012), tumor site (axial, 29.2%; limb, 61.7%; P < .0001), and primary metastases (yes, 26.7%; no, 64.4%; P < .0001), and for extremity osteosarcomas, also size (≥ one third, 52.5%; < one third, 66.7%; P < .0001) and location within the limb (proximal, 49.3%; other, 63.9%; P < .0001), had significant influence on outcome. Two additional important prognostic factors were treatment related: response to chemotherapy (poor, 47.2%; good, 73.4%; P < .0001) and the extent of surgery (incomplete, 14.6%; macroscopically complete, 64.8%; P < .0001). All factors except age maintained their significance in multivariate testing, with surgical remission and histologic response emerging as the key prognostic factors. CONCLUSION: Tumor site and size, primary metastases, response to chemotherapy, and surgical remission are of independent prognostic value in osteosarcoma.

scholarly journals Survival Analysis of 3 Different Age Groups and Prognostic Factors among 402 Patients with Skeletal High-Grade Osteosarcoma. Real World Data from a Single Tertiary Sarcoma Center

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 486
Author(s):  
Richard E. Evenhuis ◽  
Ibtissam Acem ◽  
Anja J. Rueten-Budde ◽  
Diederik S. A. Karis ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Medical Center ◽  
Age Groups ◽  
High Grade ◽  
Real World Data ◽  
Poor Overall Survival ◽  
Histopathological Response ◽  
Curative Intent ◽  
Entire Cohort ◽  
High Grade Osteosarcoma

Age is a known prognostic factor for many sarcoma subtypes, however in the literature there are limited data on the different risk profiles of different age groups for osteosarcoma survival. This study aims to provide an overview of survival in patients with high-grade osteosarcoma in different age groups and prognostic variables for survival and local control among the entire cohort. In this single center retrospective cohort study, 402 patients with skeletal high-grade osteosarcoma were diagnosed and treated with curative intent between 1978 and 2017 at the Leiden University Medical Center (LUMC). Prognostic factors for survival were analyzed using a Cox proportional hazard model. In this study poor overall survival (OS) and event-free survival (EFS) were associated with increasing age. Age groups, tumor size, poor histopathological response, distant metastasis (DM) at presentation and local recurrence (LR) were important independent prognostic factors influencing OS and EFS. Differences in outcome among different age groups can be partially explained by patient and treatment characteristics.

Influence of prognostic factors in pediatric high-grade osteosarcoma survival.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 9572-9572
Author(s):  
A. Castellanos-Toledo ◽  
R. Rivera-Luna ◽  
R. Cardenas-Cardos ◽  
J. d. J. Figueroa Carbajal ◽  
C. A. Leal-Cavazos
Keyword(s):  
Prognostic Factors ◽  
High Grade ◽  
High Grade Osteosarcoma

scholarly journals High-Grade Osteosarcoma of the Foot: Presentation, Treatment, Prognostic Factors, and Outcome of 23 Cooperative Osteosarcoma Study Group COSS Patients

Sarcoma ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Anne J. Schuster ◽  
Leo Kager ◽  
Peter Reichardt ◽  
Daniel Baumhoer ◽  
Monika Csóka ◽  
...  
Keyword(s):  
Poor Response ◽  
Study Group ◽  
High Grade ◽  
Rare Presentation ◽  
Primary Tumors ◽  
Free Survival ◽  
Primary Surgery ◽  
Tumor Entity ◽  
High Grade Osteosarcoma

Osteosarcoma of the foot is a very rare presentation of a rare tumor entity. In a retrospective analysis, we investigated tumor- and treatment-related variables and outcome of patients registered in the Cooperative Osteosarcoma Study Group (COSS) database between January 1980 and April 2016 who suffered from primary high-grade osteosarcoma of the foot. Among the 23 eligible patients, median age was 32 years (range: 6–58 years), 10 were female, and 13 were male. The tarsus was the most commonly affected site (n=16). Three patients had primary metastases. All patients were operated: 5 underwent primary surgery and 18 received surgery following preoperative chemotherapy. In 21 of the 23 patients, complete surgical remission was achieved. In 4 of 17 patients, a poor response to neoadjuvant chemotherapy was observed in the resected primary tumors. Median follow-up was 4.2 years (range: 0.4–18.5). At the last follow-up, 15 of the 23 patients were alive and 8 had died. Five-year overall and event-free survival estimates were 64% (standard error (SE) 12%) and 54% (SE 13%), which is similar to that observed for osteosarcoma in general. Event-free and overall survival correlated with primary metastatic status and completeness of surgery. Our findings show that high-grade osteosarcoma in the foot has a similar outcome as osteosarcoma of other sites.

scholarly journals Analysis of Prognostic Factors in High-Grade Osteosarcoma of the Extremities in Children: A 15-Year Single-Institution Experience

2016 ◽  
Vol 6 ◽  
Author(s):  
Liliana Vasquez ◽  
Fanny Tarrillo ◽  
Monica Oscanoa ◽  
Ivan Maza ◽  
Jenny Geronimo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Grade ◽  
Single Institution ◽  
High Grade Osteosarcoma

scholarly journals Clinical Features and Outcomes Differ between Skeletal and Extraskeletal Osteosarcoma

Sarcoma ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Sheila Thampi ◽  
Katherine K. Matthay ◽  
W. John Boscardin ◽  
Robert Goldsby ◽  
Steven G. DuBois
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Clinical Features ◽  
Older Patients ◽  
High Grade ◽  
Tumor Site ◽  
Extraskeletal Osteosarcoma ◽  
Tissue Of Origin ◽  
High Grade Osteosarcoma

Background. Extraskeletal osteosarcoma (ESOS) is a rare subtype of osteosarcoma. We investigated patient characteristics, overall survival, and prognostic factors in ESOS.Methods. We identified cases of high-grade osteosarcoma with known tissue of origin in the Surveillance, Epidemiology, and End Results database from 1973 to 2009. Demographics were compared using univariate tests. Overall survival was compared with log-rank tests and multivariate analysis using Cox proportional hazards methods.Results. 256/4,173 (6%) patients with high-grade osteosarcoma had ESOS. Patients with ESOS were older, were more likely to have an axial tumor and regional lymph node involvement, and were female. Multivariate analysis showed ESOS to be favorable after controlling for stage, age, tumor site, gender, and year of diagnosis [hazard ratio 0.75 (95% CI 0.62 to 0.90);p=0.002]. There was an interaction between age and tissue of origin such that older patients with ESOS had superior outcomes compared to older patients with skeletal osteosarcoma. Adverse prognostic factors in ESOS included metastatic disease, larger tumor size, older age, and axial tumor site.Conclusion. Patients with ESOS have distinct clinical features but similar prognostic factors compared to skeletal osteosarcoma. Older patients with ESOS have superior outcomes compared to older patients with skeletal osteosarcoma.

CNS-Disease in Elderly Patients Treated with Modern Chemotherapy (CHOP-14) with or without Rituximab: An Analysis of CNS Events in the RICOVER-60 Trial of the German High-Grade Non-Hodgkin’s Lymphoma Study Group (DSHNHL).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 519-519 ◽  
Author(s):  
Volkmar Boehme ◽  
Samira Zeynalova ◽  
Eva Lengfelder ◽  
Astrid Franke ◽  
Marcel Reiser ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Prognostic Factors ◽  
Median Time ◽  
Relapse Rate ◽  
Aggressive Lymphoma ◽  
Study Group ◽  
High Grade ◽  
Cns Disease ◽  
Cns Relapse ◽  
Lymphoma Study Group

Abstract Background CNS recurrence of aggressive lymphoma remains a distressing and usually incurable event. In an analysis of patients on protocols of the German High-Grade Non-Hodgkin’s Lymphoma Study Group (DSHNHL) between 1990 and 2000, the CNS relapse rate was 2.2% in 1693 patients treated with modern chemotherapy but without rituximab (Boehme et al., Ann. Oncol. 2007). We now analyzed the incidence and prognostic factors for CNS recurrence in the RICOVER-60 study (Pfreundschuh et al., Blood abstract 2006) where patients had been randomized to 6 or 8 courses of CHOP-14 +/- rituximab. Patients and Methods From 2000–2005, 1242 patients (pts.) between 61 and 80 years with CD20+ aggressive lymphoma were randomized to receive 6 or 8 cycles of CHOP-14 chemotherapy with or without 8 courses of rituximab. Twenty patients were excluded because of missing or retracted informed consent, leaving 1222 pts. for the intention-to-treat analysis. For patients with suspected or confirmed lymphoma manifestation in testes, bone marrow, upper cervical nodes, sinuses or other extranodal involvements in the cranial region the protocol asked for intrathecal (i.th.) prophylaxis with 15 mg methotrexate twice in the first two cycles of treatment. Results 1217 patients were evaluable, of whom 58 patients (4.8%) after a median time of 8 months (1–39) developed relapse or progression to the CNS with a median time of survival of 3 months (0.1–38). Multivariate Cox regresssion analysis identified involvement of more than one extranodal site (RR = 3.4; p< 0.001), the presence of B-symptoms (RR = 1.9; p = 0.025) and increased LDH values (RR = 1.5; p = 0.146) as relevant predictors of CNS recurrence. Patients with these three characteristics had a CNS relapse rate of approximately 24% at 2 years, about 6-fold the incidence rate observed in all other patients. The addition of rituximab to chemotherapy reduced the risk of CNS recurrence (RR = 0.5; p = 0.025), whereas the number of treatment cycles (6 vs. 8) did have no influence on the CNS-specific outcome. 273 of 1217 patients (22%) received i.th. prophylaxis at least during one cycle and 202 of 273 prophylaxis patients (74%) were treated intrathecally in full compliance with the protocol, thus reducing the rate of CNS complications (RR = 0.3; p = 0.023). The majority of these patients had involvement of testes, bone marrow, sinuses or upper skeletal and/or nodal sites. Conclusion The incidence of CNS relapse in 1217 patients treated for aggressive lymphoma with CHOP-14 with or without rituximab was low (4.8%) but slightly higher than reported in other recent series. The prognostic factors for CNS-disease and the poor prognosis of CNS relapse remain largely unchanged although rituximab significantly reduced the incidence of CNS disease (3.6 vs. 5.9%) and the risk of CNS recurrence (RR 0.5; p = 0.025). Prophylactic i.th. therapy given to patients with distinct extranodal involvement reduces the risk of CNS disease in these individuals. Due to the low overall incidence general prophylactic strategies cannot be recommended.

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