TY - JOUR
T1 - Extraskeletal osteosarcoma. A European Musculoskeletal Oncology Society study on 266 patients
AU - Longhi, A.
AU - Bielack, S. S.
AU - Grimer, Robert
AU - Whelan, J.
AU - Windhager, Reinhard
AU - Leithner, Andreas
AU - Gronchi, A.
AU - Biau, David
AU - Jutte, Paul C.
AU - Krieg, A. H.
AU - Klenke, F. M.
AU - Grignani, G.
AU - Donati, D. M.
AU - Capanna, R.
AU - Casanova, Jordi
AU - Gerrand, C
AU - Bisogno, G
AU - Hecker-Nolting, Stefanie
AU - Lisa, M.
AU - D'Ambrosio, L.
AU - Willegger, M.
AU - Scoccianti, Guido
AU - Ferrari, S.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Purpose Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis. Patients and methods Members of the European Musculoskeletal Oncology Society (EMSOS) submitted institutional data on patients with ESOS. Results Data from 274 patients treated from 1981 to 2014 were collected from 16 EMSOS centres; 266 patients were eligible. Fifty (18.7%) had metastases at diagnosis. Of 216 patients with localised disease, 211 (98%) underwent surgery (R0 = 70.6%, R1 = 27%). Five-year overall survival (OS) for all 266 patients was 47% (95% CI 40–54%). Five-year OS for metastatic patients was 27% (95% CI 13–41%). In the analysis restricted to the 211 localised patients who achieved complete remission after surgery 5-year OS was 51.4% (95% CI 44–59%) and 5-year disease-free survival (DFS) was 43% (95% CI 35–51%). One hundred twenty-one patients (57.3%) received adjuvant or neoadjuvant chemotherapy and 80 patients (37.9%) received radiotherapy. A favourable trend was seen for osteosarcoma-type chemotherapy versus soft tissue sarcoma-type (doxorubicin ± ifosfamide) regimens. For the 211 patients in complete remission after surgery, patient age, tumour size, margins and chemotherapy were positive prognostic factors for DFS and OS by univariate analysis. At multivariate analysis, patient age (≤40 years versus >40 years) (P = 0.05), tumour size (P = 0.0001) and receipt of chemotherapy (P = 0.006) were statistically significant prognostic factors for survival. Conclusion Patient age and tumour size are factors influencing ESOS prognosis. Higher survival was observed in patients who received perioperative chemotherapy with a trend in favour of multiagent osteosarcoma-type regimen which included doxorubicin, ifosfamide and cisplatin.
AB - Purpose Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis. Patients and methods Members of the European Musculoskeletal Oncology Society (EMSOS) submitted institutional data on patients with ESOS. Results Data from 274 patients treated from 1981 to 2014 were collected from 16 EMSOS centres; 266 patients were eligible. Fifty (18.7%) had metastases at diagnosis. Of 216 patients with localised disease, 211 (98%) underwent surgery (R0 = 70.6%, R1 = 27%). Five-year overall survival (OS) for all 266 patients was 47% (95% CI 40–54%). Five-year OS for metastatic patients was 27% (95% CI 13–41%). In the analysis restricted to the 211 localised patients who achieved complete remission after surgery 5-year OS was 51.4% (95% CI 44–59%) and 5-year disease-free survival (DFS) was 43% (95% CI 35–51%). One hundred twenty-one patients (57.3%) received adjuvant or neoadjuvant chemotherapy and 80 patients (37.9%) received radiotherapy. A favourable trend was seen for osteosarcoma-type chemotherapy versus soft tissue sarcoma-type (doxorubicin ± ifosfamide) regimens. For the 211 patients in complete remission after surgery, patient age, tumour size, margins and chemotherapy were positive prognostic factors for DFS and OS by univariate analysis. At multivariate analysis, patient age (≤40 years versus >40 years) (P = 0.05), tumour size (P = 0.0001) and receipt of chemotherapy (P = 0.006) were statistically significant prognostic factors for survival. Conclusion Patient age and tumour size are factors influencing ESOS prognosis. Higher survival was observed in patients who received perioperative chemotherapy with a trend in favour of multiagent osteosarcoma-type regimen which included doxorubicin, ifosfamide and cisplatin.
KW - EMSOS
KW - Extraskeletal osteosarcoma
KW - Localised osteosarcoma
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U2 - 10.1016/j.ejca.2016.12.016
DO - 10.1016/j.ejca.2016.12.016
M3 - Article
AN - SCOPUS:85012257911
VL - 74
SP - 9
EP - 16
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
ER -