TY - JOUR
T1 - Factors influencing survival after recurrence in osteosarcoma
T2 - A report from the Children's Oncology Group
AU - Spraker-Perlman, Holly L.
AU - Barkauskas, Donald A.
AU - Krailo, Mark D.
AU - Meyers, Paul A.
AU - Schwartz, Cindy L.
AU - Doski, John
AU - Gorlick, Richard
AU - Janeway, Katherine A.
AU - Isakoff, Michael S.
N1 - Funding Information:
Research was supported by the Chair's Grant U10CA98543 and Human Specimen Banking Grant U2CA114766 of the Children's Oncology Group from the National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. Additional support was provided by both the NCTN Operations Center Grant U10CA180886 and NCTN Statistics & Data Center Grant U10CA180899 (current grants, as of 3/1/14). Additional support for research is provided by a grant from the WWWW (QuadW) Foundation, Inc. (www.QuadW.org) to the Children's Oncology Group. MI receives funding from the Reid R. Sacco AYA Cancer Alliance. Finally, this research was also supported by the St. Baldrick's Foundation.
Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Background: Despite drastic improvement in overall survival for pediatric patients with cancer, those with osteosarcoma have stable rates of survival since the 1980s. This project evaluates the effect of several variables on survival after first recurrence in patients with osteosarcoma. Methods: Data from three prospective North American cooperative group trials for newly diagnosed osteosarcoma are included: INT-0133, POG-9754, and AOST0121. The analytic population for this study is all enrolled patients with first event-free survival (EFS) event of relapse. The primary outcome measure for this retrospective analysis was survival after recurrence (SAR). Results: The analytic population consisted of N = 431 patients. SAR was statistically significantly associated with age at enrollment (<10 years, P = 0.027), presence of metastatic disease at diagnosis (localized, P < 0.0001), site of relapse (combination lung + bone, unfavorable, P = 0.005), and time to first relapse (2+ years, favorable, P < 0.0001) in multivariate analysis. Ethnicity, primary site of tumor, race, and sex were not significantly related to SAR. Conclusions: Prolonged SAR in patients with relapsed osteosarcoma is associated with age, extent of disease at diagnosis, site of and time to relapse. Adolescent and young adult patients with osteosarcoma have shorter SAR than younger patients, consistent with studies showing decreased overall survival in this group. Although patients with primary metastatic disease have shorter SAR, there is a subset of patients who relapse greater than 2 years from initial diagnosis that will become survivors. Histological response was significantly associated with time to relapse, but was not predictive of SAR.
AB - Background: Despite drastic improvement in overall survival for pediatric patients with cancer, those with osteosarcoma have stable rates of survival since the 1980s. This project evaluates the effect of several variables on survival after first recurrence in patients with osteosarcoma. Methods: Data from three prospective North American cooperative group trials for newly diagnosed osteosarcoma are included: INT-0133, POG-9754, and AOST0121. The analytic population for this study is all enrolled patients with first event-free survival (EFS) event of relapse. The primary outcome measure for this retrospective analysis was survival after recurrence (SAR). Results: The analytic population consisted of N = 431 patients. SAR was statistically significantly associated with age at enrollment (<10 years, P = 0.027), presence of metastatic disease at diagnosis (localized, P < 0.0001), site of relapse (combination lung + bone, unfavorable, P = 0.005), and time to first relapse (2+ years, favorable, P < 0.0001) in multivariate analysis. Ethnicity, primary site of tumor, race, and sex were not significantly related to SAR. Conclusions: Prolonged SAR in patients with relapsed osteosarcoma is associated with age, extent of disease at diagnosis, site of and time to relapse. Adolescent and young adult patients with osteosarcoma have shorter SAR than younger patients, consistent with studies showing decreased overall survival in this group. Although patients with primary metastatic disease have shorter SAR, there is a subset of patients who relapse greater than 2 years from initial diagnosis that will become survivors. Histological response was significantly associated with time to relapse, but was not predictive of SAR.
KW - adolescent/young adult (AYA)
KW - histological response
KW - prognosis
KW - recurrent osteosarcoma
KW - survival after recurrence
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U2 - 10.1002/pbc.27444
DO - 10.1002/pbc.27444
M3 - Article
C2 - 30255612
AN - SCOPUS:85053765635
SN - 1545-5009
VL - 66
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 1
M1 - e27444
ER -