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VIEW ALL NEWSSurgical remission of osteosarcoma predicts survival
NEW YORK (Reuters Health) - Although the prognosis for patients with osteosarcoma recurrence is poor, surgical clearance can allow substantial survival for some, according to German and Austrian researchers.
In a December 15th on-line publication in the Journal of Clinical Oncology, Dr. Stefan S. Bielack of Klinikum Stuttgart and colleagues say there is less than a 20% long-term survival after osteosarcoma recurrence. However, there have been no large-scale analyses of unselected patients who experience osteosarcoma recurrences.
To gain more information, the researchers examined data for 249 heavily pretreated patients who underwent combined modality therapy and subsequently developed a total of 409 recurrences.
Five-year overall and event-free survival after the second occurrence was 16% and 9%, respectively. The corresponding proportions after the third, fourth and fifth recurrences were 14% and 0%; 13% and 6%; and 18% and 0%.
Surgery played a pivotal role in outcome. Only 1 of 205 patients without surgical remission survived beyond 5 years. However following renewed surgical remission, 5-year survival was 32% with a second recurrence, 26% with a third, 28% with a fourth and 53% with a fifth.
Chemotherapy extended the survival in patients without surgical remission.
"Patients who develop more than one cancer recurrence are often thought of as incurable," Dr. Bielack told Reuters Health. "In osteosarcoma, the most frequent primary cancer of bone, however, a few patients may survive even multiple bouts of disease."
"Complete surgical removal of all tumor lesions," he concluded, "must be attempted if cure is to be achieved."
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