Poor Survival for Osteosarcoma of the Pelvis: A Report from the Children’s Oncology Group

Isakoff, Michael S.; Barkauskas, Donald A.; Ebb, David H.; Morris, Carol D.; Letson, G. Douglas

doi:10.1007/s11999-012-2284-9

Cited by 47 publications

(50 citation statements)

References 21 publications

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“…These results are better than those reported in the literature, with 72% survival at five years for Ewing's sarcoma and 22% for osteosarcoma. 4,39,40 In our opinion the other reported reconstruction techniques have some disadvantages. The use of homologous bone needs precise pre-operative planning and might be associated with a higher infection rate because of the dead space.…”

Section: Discussionmentioning

confidence: 86%

Pelvic reconstruction with compound osteosynthesis following hemipelvectomy

Gebert

Weßling

Gosheger

et al. 2013

The Bone & Joint Journal

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To date, all surgical techniques used for reconstruction of the pelvic ring following supra-acetabular tumour resection produce high complication rates. We evaluated the clinical, oncological and functional outcomes of a cohort of 35 patients (15 men and 20 women), including 21 Ewing's sarcomas, six chondrosarcomas, three sarcomas not otherwise specified, one osteosarcoma, two osseous malignant fibrous histiocytomas, one synovial cell sarcoma and one metastasis. The mean age of the patients was 31 years (8 to 79) and the latest follow-up was carried out at a mean of 46 months (1.9 to 139.5) post-operatively. We undertook a functional reconstruction of the pelvic ring using polyaxial screws and titanium rods. In 31 patients (89%) the construct was encased in antibiotic-impregnated polymethylmethacrylate. Preservation of the extremities was possible for all patients. The survival rate at three years was 93.9% (95% confidence interval (CI) 77.9 to 98.4), at five years it was 82.4% (95% CI 57.6 to 93.4). For the 21 patients with Ewing's sarcoma it was 95.2% (95% CI 70.7 to 99.3) and 81.5% (95% CI 52.0 to 93.8), respectively. Wound healing problems were observed in eight patients, deep infection in five and clinically asymptomatic breakage of the screws in six. The five-year implant survival was 93.3% (95% CI 57.8 to 95.7). Patients were mobilised at a mean of 3.5 weeks (1 to 7) post-operatively. A post-operative neurological defect occurred in 12 patients. The mean Musculoskeletal Tumor Society score at last available follow-up was 21.2 (10 to 27). This reconstruction technique is characterised by simple and oncologically appropriate applicability, achieving high primary stability that allows early mobilisation, good functional results and relatively low complication rates.

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Section: Discussionmentioning

confidence: 86%

Pelvic reconstruction with compound osteosynthesis following hemipelvectomy

Gebert

Weßling

Gosheger

et al. 2013

The Bone & Joint Journal

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“…In our study, the proportions of primary lesion at the pelvis presented similar to other reports; 6.3% (24 of 343 patients) in a whole group and 7.2% (21 of 259 patients) in group with 20 -40 years of age. For the outcome, there is a perception that pelvic osteosarcomas have more dismal prognosis than the other sites [17]. Among the studies with relatively more cases, Ozaki et al However, compared to cases with lesions at the extremities, the survival rates of the pelvic osteosarcoma were much more unfavorable with statistical significance (p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Is Osteosarcoma between the Two Peak Ages Different?

Chung¹,

Cho²,

Jeon³

et al. 2018

JCT

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Background: Unlike two known peak age groups (10 -14 and older than 65 years of age), there was relatively scant attention in osteosarcoma patients between them, and previous reports had analyzed other than Asians. Therefore we conducted this study with Korean patients and focused on 20 -40 years of age, then investigated age-specific or race-specific meaningful outcomes. Materials and Methods: 379 patients who were newly diagnosed as osteosarcoma in two Korean major cancer hospitals from September 1986 to July 2015 with more than 2-year follow-up were retrospectively studied. There were 290 patients with 20 -40 years of age, 60 patients aged 19 or younger, and 29 patients aged 41 or older. Age at diagnosis, gender, location of primary lesion, metastasis at diagnosis, histologic subtypes, histologic response were analyzed as prognostic factors by overall survival (OS) and event-free survival (EFS) rates. Results: Primary pelvic lesion and poor histologic response were significantly unfavorable prognostic factors, but not age-specific. However, proportion of metastasis at diagnosis was significantly highest in 20 -40 years of age group. For the age at diagnosis, older patients presented poorer 5-year OS and EFS rates, but for 10-year, 20 -40 years of age group showed unusually better prognosis than younger age's, with statistic significance in OS rates but not in EFS rates. Conclusion: Osteosarcoma patients with 20 -40 years of age in Korea presented relatively better prognosis after longer-term 10-year despite their late diagnosis causing more metastasis at diagnosis, which emphasized expedite diagnosis and appropriate treatment to expect much better prognosis than peak age groups.

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“…Resectability may be compromised because of the size, involvement of visceral organs or medial extension with involvement of neural structures in the sacrum 1. There is a perception that pelvic osteosarcomas have a dismal prognosis 1249. This series selectively analyses the morbidity, functional and oncologic outcomes of nonmetastatic primary pelvic osteosarcomas appropriately treated with adequate resection in a multidisciplinary setting.…”

Section: Discussionmentioning

confidence: 99%

Outcome of surgical resection of pelvic osteosarcoma

Puri

Gulia

Pruthi

2014

IJOO

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Background:The aim of the following study is to evaluate the morbidity, oncologic results and functional outcome in nonmetastatic patients with primary osteosarcoma of the pelvis treated with surgical resection.Materials and Methods:Twelve cases of nonmetastatic osteosarcoma of pelvis were operated as part of their multimodality treatment regime between November 2003 and May 2011. There were 5 males and 7 females with a median age of 22 years (range 8-39 years). Ten patients underwent limb sparing resections while 2 had a hindquarter amputation. All 10 cases of limb sparing surgery included resection of the acetabulum. A pseudarthrosis was carried out in 7 cases. Extracorporeal radiation therapy and reimplantation of the bone followed by fixation with plates was used in 1 case and an ischiofemoral arthrodesis was carried out in 2 cases.Results:Surgical margins were free in 11 patients. Seven patients had a poor histological response to chemotherapy while 4 patients had a good response to chemotherapy. In the patient reconstructed with radiated auto bone graft, the histological response to chemotherapy could not be assessed. Surgery related complications were seen in 8 out of 12 patients (67%). Three of these patients (25%) required additional surgical intervention for their complications. All patients were available for followup. The median followup of survivors was 56 months (range 24-102 months). Four patients (33%) developed a local recurrence. At 5 years, overall survival was 67%. Patients with a good response to chemotherapy had a better overall survival when compared with patients with a poor response to chemotherapy. The mean Musculoskeletal Tumor Society functional score was 22 (range12-27).Conclusions:Though complex and challenging, surgery provides good local control and oncologic outcomes with acceptable function in patients with osteosarcoma of the pelvis treated with appropriate surgical resection as part of their multimodality treatment.

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Poor Survival for Osteosarcoma of the Pelvis: A Report from the Children’s Oncology Group

Cited by 47 publications

References 21 publications

Pelvic reconstruction with compound osteosynthesis following hemipelvectomy

Pelvic reconstruction with compound osteosynthesis following hemipelvectomy

Is Osteosarcoma between the Two Peak Ages Different?

Outcome of surgical resection of pelvic osteosarcoma

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