Patterns of care and survival for patients aged under 40 years with bone sarcoma in Britain, 1980–1994

Abstract

The purpose of the study was to calculate population-based survival rates for osteosarcoma (OS) and Ewing's sarcoma (ES) in Great Britain during 1980 -1994, determine proportions of patients treated at specialist centres or entered in national and international clinical trials, and investigate effects of these factors on survival. Data on a population-based series of 1349 patients with OS and 849 with ES were compiled from regional and national cancer registries, UK Children's Cancer Study Group, regional bone tumour registries and clinical trials. Follow-up was through population registers. Survival was analysed by actuarial analysis with log-rank tests and by Cox's proportional hazards analysis. Five-year survival rates during 1980 -1984, 1985 -1989 and 1990 -1994 were 42% (95% CI: 37, 46), 54% (95% CI: 50, 59) and 53% (95% CI: 48, 57), respectively, for OS and 31% (95% CI: 26, 37), 46% (95% CI: 40, 51) and 51% (95% CI: 45, 57) for ES. Proportions of patients treated at a supraregional bone tumour centre or a paediatric oncology centre in the three quinquennia were 36, 56 and 67% for OS and 41, 60 and 69% for ES. In 1983 -1992, 48% of OS patients were entered in a national trial; for ES, 27% were entered in 1980 -1986 and 54% in 1987 -1994. Survival was similar for trial and nontrial patients with OS. For ES, trial patients had consistently higher 5-year survival than nontrial patients : 1980 -1986 1987 1993-1994 , 54 vs 43%. During 1985-1994, patients with OS or ES whose main treatment centre was a nonteaching hospital had lower survival rates. In multivariate analyses of patients diagnosed during 1985 -1994 that also included age, sex, primary site, surgical treatment centre, the results relating to main treatment centre for both OS and ES retained significance but the survival advantage of trial entry for ES became nonsignificant. For both OS and ES diagnosed since 1985, patients whose main treatment centre was a nonspecialist hospital had a lower survival rate.

Incidence and survival of childhood bone cancer in northern England and the West Midlands, 1981–2002

“…For osteosarcoma and Ewing sarcoma, 5-year survival also improved from 37 to 61% and from 34 to 66%, respectively over this period (Stiller et al, 2006a). We describe the incidence and survival from bone tumours at ages 0 -14 years in northern England and the West Midlands during the period 1981-2002, updating previous analyses (Cotterill et al, 2000Stiller et al, 2006c).…”

“…Gender was not significant in relation to survival for osteosarcoma or Ewing sarcoma, as reported for Ewing sarcoma in the United Kingdom (Stiller et al, 2006c). However, a recent study of Ewing sarcoma from the United States of America has reported a higher 5-year survival rate in females than males (Esiashvili et al, 2008).…”

Postoperative Radiochemotherapy With Weekly Cisplatin in Patients With Head and Neck Cancer Single-Institution Outcome Analysis

“…However, reports from the area of head and neck cancer are rare [28][29][30]. In the present study, surgery was performed in university centres or regional hospitals and there was some indication that survival was higher in patients from university centres than from other hospitals.…”

Osteosarcoma in Finland from 1971 through 1990 A nationwide study of epidemiology and outcome

“…To our knowledge, only three nationwide, population-based studies on clinical presentation and prognosis of osteosarcoma have been publishedbut without histological reexamination (Larsson and Lorentzon 1974, Curry et al 2006, Stiller et al 2006. Stiller et al (2006) collected information on all patients with osteosarcoma in Britain during 1980-1994 from the National Registry of Childhood Tumours, regional cancer registries in England, the national cancer registries in Scotland and Wales, the UK Children's Cancer Study Group register, special bone tumor centers, and the Birmingham Bone Tumour Service.…”