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Characterization of localized osteosarcoma of the extremity in children, adolescents, and young adults from a single institution in South Texas.

Sugalski AJ, Jiwani A, Ketchum NS, Cornell J, Williams R, Heim-Hall J, Hung JY, Langevin AM - J. Pediatr. Hematol. Oncol. (2014)

Bottom Line: We observed a significantly decreased 5-year event-free survival in patients diagnosed before age 12 relative to patients diagnosed between ages 12 and 29 (11% vs. 57%, P<0.001).We also found that tumor necrosis was not predictive of outcome in our patients.The preadolescent patients of predominately Mexican American ethnicity had an increased rate of relapse when compared with previous studies.

View Article: PubMed Central - PubMed

Affiliation: *Greehey Children's Cancer Research Institute Departments of †Pediatrics, Division of Hematology and Oncology §Epidemiology and Biostatistics ∥Orthopedics ¶Pathology ‡School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX.

ABSTRACT

Background: Osteosarcoma is the most common bone malignancy in children, adolescents, and young adults. Most study cohorts have 10% to 15% Hispanic patients that encompass many different Hispanic backgrounds. This study characterizes the effect of mainly Mexican American ethnicity on the outcome of children, adolescents, and young adults with osteosarcoma.

Methods: A retrospective analysis of demographics, tumor characteristics, response to treatment, and survival outcome of all localized osteosarcoma of the extremity patients below 30 years of age was performed. A Kaplan-Meier estimates with log-rank tests and Cox proportional hazard regression models were used.

Results: Fifty patients (median age, 15; range, 2 to 28 y) with localized high-grade osteosarcoma of the extremity were diagnosed between January 2000 and December 2010. The cohort was 70% Mexican Americans. With a median follow-up of 39 months (range, 5 to 142 mo), patients had a 5-year overall survival and event-free survival of 65% and 48%, respectively. We observed a significantly decreased 5-year event-free survival in patients diagnosed before age 12 relative to patients diagnosed between ages 12 and 29 (11% vs. 57%, P<0.001). We also found that tumor necrosis was not predictive of outcome in our patients.

Conclusions: The preadolescent patients of predominately Mexican American ethnicity had an increased rate of relapse when compared with previous studies. Tumor necrosis is not directly predictive of outcome in this population.

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Event-free survival (EFS) of localized/extremity tumor patients based on tumor necrosis. The 5-year EFS for patients with grades 5 to 6 was significantly different than the 5-year EFS of patients with grades 1 to 3 and grade 4 tumor necrosis (P=0.03).
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Figure 1: Event-free survival (EFS) of localized/extremity tumor patients based on tumor necrosis. The 5-year EFS for patients with grades 5 to 6 was significantly different than the 5-year EFS of patients with grades 1 to 3 and grade 4 tumor necrosis (P=0.03).

Mentions: Although response to neoadjuvant chemotherapy has traditionally been used as a prognostic marker for both EFS and OS, it was of prognostic significance only for EFS (Table 2 and Figs. 1, 2) in our population. We observed an increased percentage of patients with <50% necrosis after neoadjuvant chemotherapy and chose to grade necrosis based on 6 categories as defined by Salzer-Kuntschik et al4 to further categorize the “poor responders.” The 5-year EFS when compared between groups categorized by grades 1 to 3, grade 4, and grades 5 to 6 necrosis showed a statistically significant decreased outcome in patients with grades 5 to 6 necrosis (61% vs. 42% vs. 21%, respectively, P=0.03). The 5-year OS for these patients was similar across the groups suggesting that our patient population was salvageable after initial relapse.


Characterization of localized osteosarcoma of the extremity in children, adolescents, and young adults from a single institution in South Texas.

Sugalski AJ, Jiwani A, Ketchum NS, Cornell J, Williams R, Heim-Hall J, Hung JY, Langevin AM - J. Pediatr. Hematol. Oncol. (2014)

Event-free survival (EFS) of localized/extremity tumor patients based on tumor necrosis. The 5-year EFS for patients with grades 5 to 6 was significantly different than the 5-year EFS of patients with grades 1 to 3 and grade 4 tumor necrosis (P=0.03).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222611&req=5

Figure 1: Event-free survival (EFS) of localized/extremity tumor patients based on tumor necrosis. The 5-year EFS for patients with grades 5 to 6 was significantly different than the 5-year EFS of patients with grades 1 to 3 and grade 4 tumor necrosis (P=0.03).
Mentions: Although response to neoadjuvant chemotherapy has traditionally been used as a prognostic marker for both EFS and OS, it was of prognostic significance only for EFS (Table 2 and Figs. 1, 2) in our population. We observed an increased percentage of patients with <50% necrosis after neoadjuvant chemotherapy and chose to grade necrosis based on 6 categories as defined by Salzer-Kuntschik et al4 to further categorize the “poor responders.” The 5-year EFS when compared between groups categorized by grades 1 to 3, grade 4, and grades 5 to 6 necrosis showed a statistically significant decreased outcome in patients with grades 5 to 6 necrosis (61% vs. 42% vs. 21%, respectively, P=0.03). The 5-year OS for these patients was similar across the groups suggesting that our patient population was salvageable after initial relapse.

Bottom Line: We observed a significantly decreased 5-year event-free survival in patients diagnosed before age 12 relative to patients diagnosed between ages 12 and 29 (11% vs. 57%, P<0.001).We also found that tumor necrosis was not predictive of outcome in our patients.The preadolescent patients of predominately Mexican American ethnicity had an increased rate of relapse when compared with previous studies.

View Article: PubMed Central - PubMed

Affiliation: *Greehey Children's Cancer Research Institute Departments of †Pediatrics, Division of Hematology and Oncology §Epidemiology and Biostatistics ∥Orthopedics ¶Pathology ‡School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX.

ABSTRACT

Background: Osteosarcoma is the most common bone malignancy in children, adolescents, and young adults. Most study cohorts have 10% to 15% Hispanic patients that encompass many different Hispanic backgrounds. This study characterizes the effect of mainly Mexican American ethnicity on the outcome of children, adolescents, and young adults with osteosarcoma.

Methods: A retrospective analysis of demographics, tumor characteristics, response to treatment, and survival outcome of all localized osteosarcoma of the extremity patients below 30 years of age was performed. A Kaplan-Meier estimates with log-rank tests and Cox proportional hazard regression models were used.

Results: Fifty patients (median age, 15; range, 2 to 28 y) with localized high-grade osteosarcoma of the extremity were diagnosed between January 2000 and December 2010. The cohort was 70% Mexican Americans. With a median follow-up of 39 months (range, 5 to 142 mo), patients had a 5-year overall survival and event-free survival of 65% and 48%, respectively. We observed a significantly decreased 5-year event-free survival in patients diagnosed before age 12 relative to patients diagnosed between ages 12 and 29 (11% vs. 57%, P<0.001). We also found that tumor necrosis was not predictive of outcome in our patients.

Conclusions: The preadolescent patients of predominately Mexican American ethnicity had an increased rate of relapse when compared with previous studies. Tumor necrosis is not directly predictive of outcome in this population.

Show MeSH
Related in: MedlinePlus