Bone metastases from osteosarcoma

Abstract

Bony metastases in patients with osteosarcoma are unusual and normally appear late in the course of the disease. We report our experience with eight such patients, four with solitary and four with multiple metastases. Those with solitary metastases were treated as new tumours with neoadjuvant chemotherapy and surgery. Three remain alive with no evidence of disease at 5, 7 and 8 years follow-up respectively. Histology and response to neoadjuvant chemotherapy was similar in both the primary and metastatic lesions and is a predictive factor of outcome. Those with multiple metastases were treated by palliative measures, and none survived. We conclude that resection of solitary metastases from osteosarcoma after neoadjuvant chemotherapy can be curative. RÉSUMÉ Les métastases osseuses chez les patients atteints d'ostéosarcome sont rares et n'apparaissent que tardivement dans l'évolution de la maladie. Nous rapportons notre expérience avec 8 patients, 4 ayant uniquement des métastases osseuses et 4 des métastases multiples. Ceux qui présentaient une seule métastase ont été traité comme une tumeur primitive avec chimiothérapie néoadjuvante et chirurgie. Trois d'entre eux sont encore vivants sans évidence de maladie après 5, 7 et 8 ans de suivi. L'histologie et la réponse à la chimiothérapie néoadjuvante ont été similaires tant pour la lésion primaire que pour les métastases. Les patients avec métastases multiples ont été traité avec des mesures palliatives. Aucun d'eux n'a survécu. On peut conclure que la résection de ces métastases après chimiothérapie néoadjuvante peut être utilisée avec une intention curative en cas de métastase osseuse unique.

Postmetastasis survival in high‐grade extremity osteosarcoma: A retrospective analysis of prognostic factors in 126 patients

“…Thus, among 21 patients with bone metastasis, metastasectomy was performed for isolated single bone metastasis in only four patients, and three of them experienced long‐term survival. We believe the survival gain in bone metastasis observed in our study may also support the strategy of aggressive metastasectomy . However, the interpretation of the data is limited by the small number of patients.…”

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

“…Patients with primary metastases are known to be associated with inferior event-free and overall survival rates [ 13 , 30 , 39 , 40 ], which was also seen in our cohort, where none of the three patients with primary metastases survived. Complete surgical remission, mostly achieved by amputation, was the strongest positive predictive factor for EFS and OS in our cohort.…”

Leptocarpin Suppresses Proliferation, Migration, and Invasion of Human Osteosarcoma by Targeting Type-1 Insulin-Like Growth Factor Receptor (IGF-1R)

“…Osteosarcoma, involving the formation of malignant osteoid or woven bone, is one of the most common tumors clinically, which frequently affects children and young adults [ 5 ]. Osteosarcoma is related to high rates of bone destruction with great biological virulence [ 6 ].…”