Survival outcomes of patients with brain metastasis of osteosarcoma can be improved by aggressive multi-disciplinary interventions including chemotherapy

Brain Metastases from Adult Sarcomas: A Retrospective Cohort Study from the Hellenic Group of Sarcomas and Rare Cancers (HGSRC)

“…ASPS has been reported to have a predisposition towards brain metastases with estimates of approximately 25% at presentation, typically occurring in young patients [14,22,23]. Osteosarcoma has also been reported to metastasize to the brain [11,17,[24][25][26], presenting usually with intralesional calcifications [27]. In our study, the most common histotypes were in agreement with the previous results.…”

“…In the study of MSKCC, the median OS in patients who underwent surgical removal of their brain metastases was 9.6 versus 2.7 months in non-operated patients [1]. However, a significantly prolonged survival was found in several analyses with treatment combinations (surgery combined with chemotherapy or radiation therapy) [4,9,17]. We also found prolonged survival with treatment combinations, including surgery plus radiation therapy and/or systemic therapy, as was the case for our long survivors.…”

“…There is a higher tendency of some histotypes to metastasize in the brain, such as osteosarcoma [11,12] and alveolar soft part sarcoma (ASPS) [5,7,13]. Different systemic or local therapies have been described that have not been sufficiently evaluated and the optimal treatment has yet to be defined [5,12,[14][15][16][17]. The prognosis is, in general, dismal, with a rather longer survival reported in patients undergoing surgery [11,12,15].…”

Brain metastases of sarcoma: a rare phenomenon in rare tumours

“…In a study of 112 patients, combining chemotherapy with surgery improved overall survival significantly, compared with combining radiotherapy with surgery or surgery alone (Al Sannaa et al 2016 ). This was partially confirmed by Zhu et al ( 2021 ), who observed the advantage over solely performed metastasectomy but failed to show the difference compared to surgery with adjuvant radiotherapy.…”

“…clear-cell sarcoma) remain chemoresistant (Chaigneau et al 2018 ). A study of aggressive multidisciplinary treatments for patients with osteosarcoma metastasizing to the brain found that chemotherapy is a favourable prognostic factor for longer overall survival, independently of surgery and radiotherapy (Zhu et al 2021 ). This is in line with results from a multicentre study of 246 sarcoma patients with CNS metastases, which also demonstrated a positive impact of chemotherapy on overall survival (Chaigneau et al 2018 ).…”