Osteosarcoma in patients younger than 12 years old without metastases have similar prognosis as adolescent and young adults

Abstract

Background Childhood cancer is relatively rare and tends to present specific age distribution, as a prognostic factor for some of these diseases. Information on how young age affects prognosis, response to chemotherapy, and local control options in children versus AYA with osteosarcoma (OST) is minimal. Methods In order to identify the main differences in clinicalpathologic features, surgical approaches and survival rates of primary high grade OST of the extremity between children (n = 156; <12 years old) and AYA (n = 397; 12–30 years old), the institutional database with 553 patients treated by BOTG studies over 15 years were reviewed. Results There were no differences in metastasess at diagnosis, tumor size, and grade of necrosis between the two age groups. The rate of amputation was 30% higher in the children group (P = 0.018). The rate of limb salvage surgery using reconstruction with allograft or autograft was 70% higher in the children group (P = 0.018) while endoprosthesis rate was 40% higher in the AYA group (P = 0.018). The log rank test revealed that survival is similar between the two age groups for non‐metastatic patients (P = 0.424 for OS and P = 0.393 for EFS). Metastatic patients of both ages group had higher risk of dying compared to non‐metastatic (HR 3.283 95% CI 2.581–4.177; P < 0.001). Children with metastases at diagnosis had less OS time (P = 0.049) and EFS time (P = 0.032) than adolescents. Conclusion Non‐metastatic OST in preadolescent patients does not appear to be significantly differentfrom those seen in AYA patients, but has local control challenges. Children presenting with metastases should be considered an ultra‐high‐risk group. Pediatr Blood Cancer 2015;62:1209–1213. © 2015 Wiley Periodicals, Inc.

The proliferation and invasion of osteosarcoma are inhibited by miR-101 via targetting ZEB2

“…Children and young adults are the susceptible population and osteosarcoma brings serious public health problems and significant economic burden [3]. Even though the diagnostic and treatment methods including computed tomography, chemotherapy, and surgery have improved prognosis of patients a lot in recent years, local recurrence occurs in approximately 10% of patients and the survival rate is only 10% in metastatic or relapse patients [4–6]. Therefore, it is urgent to excavate the molecular mechanisms for osteosarcoma progression and discover the potential molecular markers for tumor-targetted therapy.…”

Descriptive epidemiology and outcomes of bone sarcomas in adolescent and young adult patients in Japan

“…A few previous studies have investigated the clinical outcomes of AYAs with bone sarcoma using nationwide or large databases with sufficient numbers of patients. However, most previous studies were based on data derived from small numbers of cases, and those with larger sample sizes have only analyzed a few disease-related factors [ 7 – 11 ].…”

Treatment of osteosarcoma around the knee in skeletally immature patients

“…With rising survival rates following chemotherapy, limb salvage surgery is increasingly becoming the standard of care for the majority of malignant neoplasms affecting the extremities ( 4 , 5 ). Segmental bone loss following tumor resection requires prosthesis reconstruction in most adult patients, but may be difficult in skeletally immature patients due to the necessity to preserve the joint function maximally and maintain good limb function ( 6 ). This is a challenging situation for surgeons treating patients following epiphysis resection and limb reconstruction with the most suitable procedure in order for the least length discrepancy compared with the ongoing growth of the contralateral limb.…”