TY - JOUR
T1 - Treatment of 120 adult osteosarcoma patients with metachronous and synchronous metastases
T2 - A retrospective series of the French Sarcoma Group
AU - Lavit, Elise
AU - Aldea, Mihaela
AU - Piperno-Neumann, Sophie
AU - Firmin, Nelly
AU - Italiano, Antoine
AU - Isambert, Nicolas
AU - Kurtz, Jean Emmanuel
AU - Delcambre, Corinne
AU - Lebrun, Valérie
AU - Soibinet-Oudot, Pauline
AU - Chevreau, Christine
AU - Bompas, Emmanuelle
AU - Le Maignan, Christine
AU - Boudou-Rouquette, Pascaline
AU - Le Cesne, Axel
AU - Mancini, Julien
AU - Blay, Jean Yves
AU - Duffaud, Florence
N1 - Publisher Copyright:
© 2021 UICC.
PY - 2022/2/15
Y1 - 2022/2/15
N2 - Treatment options for metastatic osteosarcomas are scarce. Following failure of standard first line therapy, patients who relapse present a challenging treatment dilemma, and have a poor prognosis. Surgical removal of all metastases is essential. A retrospective analysis of patients with metastatic osteosarcomas was conducted in 15 French Sarcoma Group centers. From January 2009 to December 2018, we identified 120 adult patients; 36 with synchronous and 84 with metachronous metastases with 74 males and 46 females. Mean age was 30 years (18-53). Metastatic sites were lung, bone and other in 91, 11 and 24 patients, respectively. Mean time to first metachronous metastases was 22 months (4-97). All patients except 13 (10.8%) with metachronous metastases received a first line systemic treatment for relapse, and 39 patients (32.5%) were included in a clinical trial. Eighty-one patients (67.5%) had local treatment of distant metastases. Median progression free survival (PFS) and overall survival (OS) were 5.5 (95% CI 4.6-6.4) and 20.5 months (95% CI 13.2-27.7) respectively for the overall group. In multivariate analysis, more than five metastases, time to first metastases <24 months, were statistically significant negative prognostic factors for OS and PFS (P =.002, ≤.001 and P =.006, ≤.001, respectively). Surgery of metastases was associated with better prognosis on OS and PFS (P =.001 and.037, respectively). The presence of bone metastases was a negative prognostic factor on OS but not on PFS (P =.021). In reference sarcoma centers, relapsed osteosarcoma patients with more than one metastasis commonly receive more than one line of systemic therapy, and are included in clinical trial if available.
AB - Treatment options for metastatic osteosarcomas are scarce. Following failure of standard first line therapy, patients who relapse present a challenging treatment dilemma, and have a poor prognosis. Surgical removal of all metastases is essential. A retrospective analysis of patients with metastatic osteosarcomas was conducted in 15 French Sarcoma Group centers. From January 2009 to December 2018, we identified 120 adult patients; 36 with synchronous and 84 with metachronous metastases with 74 males and 46 females. Mean age was 30 years (18-53). Metastatic sites were lung, bone and other in 91, 11 and 24 patients, respectively. Mean time to first metachronous metastases was 22 months (4-97). All patients except 13 (10.8%) with metachronous metastases received a first line systemic treatment for relapse, and 39 patients (32.5%) were included in a clinical trial. Eighty-one patients (67.5%) had local treatment of distant metastases. Median progression free survival (PFS) and overall survival (OS) were 5.5 (95% CI 4.6-6.4) and 20.5 months (95% CI 13.2-27.7) respectively for the overall group. In multivariate analysis, more than five metastases, time to first metastases <24 months, were statistically significant negative prognostic factors for OS and PFS (P =.002, ≤.001 and P =.006, ≤.001, respectively). Surgery of metastases was associated with better prognosis on OS and PFS (P =.001 and.037, respectively). The presence of bone metastases was a negative prognostic factor on OS but not on PFS (P =.021). In reference sarcoma centers, relapsed osteosarcoma patients with more than one metastasis commonly receive more than one line of systemic therapy, and are included in clinical trial if available.
KW - metastatic osteosarcomas
KW - prognosis
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85116314141&partnerID=8YFLogxK
U2 - 10.1002/ijc.33823
DO - 10.1002/ijc.33823
M3 - Article
C2 - 34562271
AN - SCOPUS:85116314141
SN - 0020-7136
VL - 150
SP - 645
EP - 653
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 4
ER -