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

Abstract

There is a paucity of population-based studies examining incidence and survival trends in childhood bone tumours. We used high quality data from four population-based registries in England. Incidence patterns and trends were described using Poisson regression. Survival trends were analysed using Cox regression. There were 374 cases of childhood (ages 0 -14 years) bone tumours (206 osteosarcomas, 144 Ewing sarcomas, 16 chondrosarcomas, 8 other bone tumours) registered in the period 1981 -2002. Overall incidence (per million person years) rates were 2.63 (95% confidence interval (CI) 2.27 -2.99) for osteosarcoma, 1.90 (1.58 -2.21) for Ewing sarcoma and 0.21 (0.11 -0.31) for chondrosarcoma. Incidence of Ewing sarcoma declined at an average rate of 3.1% (95% CI 0.6 -5.6) per annum (P ¼ 0.04), which may be due to tumour reclassification, but there was no change in osteosarcoma incidence. Survival showed marked improvement over the 20 years (1981 -2000) for Ewing sarcoma (hazard ratio (HR) per annum ¼ 0.95 95% CI 0.91 -0.99; P ¼ 0.02). However, no improvement was seen for osteosarcoma patients (HR per annum ¼ 1.02 95% CI 0.98 -1.05; P ¼ 0.35) over this time period. Reasons for failure to improve survival including potential delays in diagnosis, accrual to trials, adherence to therapy and lack of improvement in treatment strategies all need to be considered.

Evaluation of Overall Survival (OS) and Event-Free Survival (EFS) of Paediatric Sarcoma Patients at a Single Institution

“…14 of the surivors have had no disease recurrence and therefore there is an event-free survival of 58%. Yorkhill's overall survival rate is comparable to UK (55%) and European (62%) studies [34]. In the metastatic group there were 5 patients, 2 of which survived past 5 years giving an overall survival rate of 40%.…”

“…7 of these patients survived for more than five years and only one had disease recurrence providing an overall survival of 64% and event-free survival of 55%. This compares to other UK studies putting overall survival at 59% and a European rate at 66% [34]. In the metastatic group there were 3 patients all of whom died, giving an overall survival rate of 0%.…”

Multimodality imaging features, metastatic pattern and clinical outcome in adult extraskeletal Ewing sarcoma: experience in 26 patients

“…5 In the UK, EES is the second most common sarcoma accounting for 39% of childhood bone sarcomas with an estimated incidence of 1.58-2.21 per million person years. 6 Most of the ESSs in the first two decades of life (up to 80%) occur in the skeleton. 7 On the contrary, extra-osseous origin is more common in adults than that in children with .50% of primary adult EESs being extra-osseous in origin.…”

Value of image-guided fine-needle aspiration cytology in the diagnosis of bone lesions

“…As reported elsewhere (Nnodu et al, 2006;Eyre et al, 2009;Layfield, 2009), osteosarcoma was the most frequent primary malignant tumor. The clinical features of age at presentation, rapid onset, radiographof an irregularly outlined osseous defect with cortical destruction, sun-burst appearance, and Codman's triangle with the characteristic cytological features mentioned previously ( Fig.…”