Metastatic Patterns in Osteosarcoma

Abstract

The clinical courses of 193 patients with high-grade, non-metastatic osteosarcoma were reviewed to ascertain the evolution of the natural history of the disease. All patients had the primary lesion in the extremities and were treated at the Rizzoli Orthopaedic Institute between 1976 and 1982 with surgery alone (30 cases) or surgery plus adjuvant chemotherapy (163 cases). All patients were regularly followed at our Institute. One hundred and fourteen patients, of which 27 were treated with surgery alone and 87 treated with adjuvant chemotherapy, developed overt metastatic disease. No differences were found concerning the sites of the first relapse which, for approximately 90% of cases, were lungs in both groups. However, in the group of patients treated with adjuvant chemotherapy the development of overt metastatic disease, as compared to non-adjuvant patients, was delayed with time (13 vs 8 months) and the number of metastatic nodules in the lung at first relapse was reduced. This alteration in metastatic pattern due to adjuvant chemotherapy is important because it allows surgical resection of pulmonary metastases in a larger number of patients (51% vs 29%).

Invasive growth and topoisomerase-switch induced by tumorous extracellular matrix in osteosarcoma cell culture

“…Several previous studies failed to model the metastatic potential of osteosarcomas in vitro, when compared to the clinical experience (Bacci et al, 1988;Hara et al, 1996;Jia et al, 1999). From the current study, it can be seen that tumor ECM needs to be considered in the investigation of invasive growth of osteosarcomas.…”

“…Human osteosarcoma is a malignant bone tumor with poor prognosis due to its propensity for metastasis preferentially to the lungs (Bacci et al, 1988). The majority of the cell lines derived from human osteosarcoma do not form metastasis in immunesuppressed mice (Jia et al, 1999), but their involvement in bone induction was suspected in the case of the Hu09 cell line (Hara et al, 1996).…”

Pulmonary nodules in osteosarcoma patients: differential diagnosis of central venous catheter–related infections in the lungs

“…The lung is often the first site of metastatic spread of many solid tumours [16], and this is particularly true for osteosarcoma. The lung is the most frequent site of metastasis (90% of all metastasis sites) of this tumour at presentation and during follow-up [17]. Osteosarcoma of the extremities tends to metastasize within the first 5 years of diagnosis in 30%-40% of cases [13].…”

“…Il polmone è spesso la sede iniziale della diffusione metastatica di molti tumori solidi [16] e ciò è particolarmente vero per l'osteosarcoma. Il polmone rappresenta, infatti, la più frequente sede (90% di tutte le sedi di metastasi) di metastasizzazione di questo tumore alla diagnosi e durante il follow-up [17]. L'osteosarcoma localizzato alle estremità tende a metastatizzare nei primi cinque anni dalla diagnosi nel 30%-40% dei casi [13].…”

Fine Needle Aspiration of Osteogenic Sarcoma Metastatic to the Lung

“…8 Despite numerous improvements on the chemotherapeutic regimens, at least 30-40% of patients will develop metastatic disease, most commonly in the lung. 2,7 New pulmonary nodules in a patient with known malignancy is almost always metastatic disease. 14 In a patient with a history of OGS, the diagnosis is extremely likely to be metastatic OGS, but a few other entities may occur.…”