Osteosarcoma recurrences in pediatric patients previously treated with intensive chemotherapy.

Tabone, Marie Dominique; Kalifa, Chantal; Rodary, C; Raquin, Marie-Anne; Valteau-Couanet, D; Lemerle, J

doi:10.1200/jco.1994.12.12.2614

Cited by 129 publications

(123 citation statements)

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“…In many series, the number of patients treated with second-line chemotherapy was too small to draw conclusions regarding the impact on survival. 7,21 Pastorino et al 13 and Tabone et al 15 observed no difference in survival with or without second-line chemotherapy. However, chemotherapy was given selectively to patients with multiple pulmonary nodules or with an RFI shorter than 1 year RFI 13 or to patients with multiple recurrent tumors or tumors that were difficult to resect.…”

Section: Discussionmentioning

confidence: 96%

“…However, chemotherapy was given selectively to patients with multiple pulmonary nodules or with an RFI shorter than 1 year RFI 13 or to patients with multiple recurrent tumors or tumors that were difficult to resect. 15 In contrast, Saeter et al 19 concluded that the delivery of "modern intensive chemotherapy" (p. 1090) improved overall survival when compared with patients treated with no or inadequate chemotherapy. In two more recent series, a benefit for second-line chemotherapy was not demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…Tabone et al 15 reported that only one of seven patients with distant bone recurrence survived disease free with short-term follow-up. Ward et al 16 reported a 4-year postrecurrence survival rate of 0% n 17 patients with distant bone recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…4 -26 The benefit of secondline chemotherapy in the treatment of recurrent OS is less clear. [7][8][9][10][11][12][13]15,16,19,20,25,26 Several factors complicate the analysis of the published literature regarding DFS and survival after OS recurrence. First, some series represented selected cohorts of patients amenable to surgical excision, thereby excluding patients with unresectable (and therefore unfavorable) recurrent tumors.…”

mentioning

confidence: 99%

“…25 Fourth, most series reported only survival rates and only three series reported DFS or event-free survival rates after disease recurrence. 12,15,26 Those rates ranged from 16% to 27%. For these reasons, the clinical features and prognostic factors associated with recurrent OS in the contemporary chemotherapy era are not well defined.…”

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Pattern of disease recurrence and prognostic factors in patients with osteosarcoma treated with contemporary chemotherapy

Hawkins

Arndt

2003

Cancer

138

120

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BACKGROUNDThe goal of the current study was to define the clinical features and outcome of recurrent osteosarcoma (OS) in children and young adults initially treated with contemporary chemotherapy.METHODSThe authors reviewed the clinical features, therapy, and outcome for 59 patients from the Mayo Clinic (Rochester, MN) and Children's Hospital and Regional Medical Center (Seattle, WA). They were diagnosed initially with OS between January 1990 and December 2000, received multiagent chemotherapy (most frequently cisplatin, doxorubicin, high‐dose methotrexate, and ifosfamide), and developed disease recurrence after achieving an initial complete response (CR).RESULTSThe most common site of initial disease recurrence was the lung only (n = 36 patients), followed by distant bone (n =8 patients), combined lung and other sites (n =7 patients), and other sites (n =8 patients). The median time to first disease recurrence was 15 months (range, 2–92 months) from the initial diagnosis. Thirty patients with isolated pulmonary recurrence achieved a second CR, either with surgery alone (n =15 patients) or surgery and salvage chemotherapy (n =15 patients). For this group, the 4‐year disease‐free survival (DFS) and overall survival rates were 7% (95% confidence interval [95% CI], 0–16%) and 28% (95% CI, 11–45%), respectively. For all 59 patients with recurrent OS, the 4‐year DFS and overall survival rates were 6% (95% CI, 0–12%) and 23% (95% CI, 10–36%), respectively. The only factors associated with improved DFS and overall survival rates were unilateral pulmonary recurrence, solitary pulmonary nodule at recurrence, more than 24 months between the initial diagnosis and first disease recurrence, and achievement of a second CR.CONCLUSIONSThe DFS and overall survival rates for recurrent OS after contemporary therapy remained poor even for patients with isolated pulmonary recurrence. Therefore, new treatment strategies are needed. Cancer 2003. © 2003 American Cancer Society.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Pattern of disease recurrence and prognostic factors in patients with osteosarcoma treated with contemporary chemotherapy

Hawkins

Arndt

2003

Cancer

138

120

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Evaluation of follow-up investigations in osteosarcoma patients: Suggestions for an effective follow-up program

Körholz

Verheyen

Kemperdick

et al. 1998

Med. Pediatr. Oncol.

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Osteogenic sarcoma of the extremity with detectable lung metastases at presentation

Bacci

Mercuri

Briccoli

et al. 1997

Cancer

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In patients presenting with osteosarcoma of the extremity with lung metastases, the combination of aggressive chemotherapy with simultaneous resection of the primary and metastatic lesions improves traditionally negative outcomes. The strong correlation found between the histologic response of the primary and metastatic tumors supports the strategy, largely used currently in the neoadjuvant treatment of osteosarcoma, of tailoring postoperative chemotherapy on the basis of the histologic response of the primary tumor to preoperative chemotherapy.

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Osteosarcoma recurrences in pediatric patients previously treated with intensive chemotherapy.

Cited by 129 publications

References 23 publications

Pattern of disease recurrence and prognostic factors in patients with osteosarcoma treated with contemporary chemotherapy

Pattern of disease recurrence and prognostic factors in patients with osteosarcoma treated with contemporary chemotherapy

Evaluation of follow-up investigations in osteosarcoma patients: Suggestions for an effective follow-up program

Osteogenic sarcoma of the extremity with detectable lung metastases at presentation

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