TY - JOUR
T1 - The role of chemotherapy and radiotherapy in localized extraskeletal osteosarcoma
AU - Japanese Musculoskeletal Oncology Group (JMOG)
AU - Soft Tissue Osteosarcoma International Collaborative (STOIC)
AU - Heng, Marilyn
AU - Gupta, Abha
AU - Chung, Peter W.
AU - Healey, John H.
AU - Vaynrub, Max
AU - Rose, Peter S.
AU - Houdek, Matthew T.
AU - Lin, Patrick P.
AU - Bishop, Andrew J.
AU - Hornicek, Francis J.
AU - Chen, Yen Lin
AU - Lozano-Calderon, Santiago
AU - Holt, Ginger E.
AU - Han, Ilkyu
AU - Biau, David
AU - Niu, Xiaohui
AU - Bernthal, Nicholas M.
AU - Ferguson, Peter C.
AU - Wunder, Jay S.
AU - Ueda, Takafumi
AU - Kakunaga, Shigeki
AU - Kawai, Akira
AU - Sugiura, Hideshi
AU - Kidani, Teruki
AU - Kunisasa, Toshiyuki
AU - Ozaki, Toshifumi
AU - Ae, Keisuke
AU - Nagano, Akihito
AU - Ohno, Takatoshi
AU - Hiraoka, Koji
AU - Yamamoto, Norio
AU - Tsuchiya, Hiroyuki
AU - Matsumoto, Yoshihiro
AU - Yanagawa, Takashi
AU - Nakayama, Robart
AU - Morioka, Hideo
AU - Kubo, Tadahiko
AU - Simose, Shoji
AU - Yamagami, Yoshiki
AU - Yamamoto, Tetsuji
AU - Kawasaki, Motohiro
AU - Torigoe, Tomoaki
AU - Yazawa, Yasuo
AU - Akiyama, Toru
AU - Gokita, Tabu
AU - Manabe, Jun
AU - Kaya, Mitsunori
AU - Patel, Shreyaskumar R.
AU - Lewis, Valerae O.
AU - Guadagnolo, B. Ashleigh
N1 - Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2020/1
Y1 - 2020/1
N2 - Purpose: The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods: Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan–Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results: 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%–62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26–0.80], p = 0.01). Conclusion: Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.
AB - Purpose: The role of chemotherapy (CT) and radiotherapy (RT) for management of extraskeletal osteosarcoma (ESOS) remains controversial. We examined disease outcomes for ESOS patients and investigated the association between CT/RT with recurrence and survival. Patients and methods: Retrospective review at 25 international sarcoma centers identified patients ≥18 years old treated for ESOS from 1971 to 2016. Patient/tumour characteristics, treatment, local/systemic recurrence, and survival data were collected. Kaplan–Meier survival and Cox proportional-hazards regression and cumulative incidence competing risks analysis were performed. Results: 370 patients with localized ESOS treated definitively with surgery presented with mainly deep tumours (n = 294, 80%). 122 patients underwent surgical resection alone, 96 (26%) also received CT, 70 (19%) RT and 82 (22%) both adjuvants. Five-year survival for patients with localized ESOS was 56% (95% CI 51%–62%). Almost half of patients (n = 173, 47%) developed recurrence: local 9% (35/370), distant 28% (102/370) or both 10% (36/370). Considering death as a competing event, there was no significant difference in cumulative incidence of local or systemic recurrence between patients who received CT, RT, both or neither (local p = 0.50, systemic p = 0.69). Multiple regression Cox analysis showed a significant association between RT and decreased local recurrence (HR 0.46 [95% CI 0.26–0.80], p = 0.01). Conclusion: Although the use of RT significantly decreased local recurrences, CT did not decrease the risk of systemic recurrence, and neither CT, nor RT nor both were associated with improved survival in patients with localized ESOS. Our results do not support the use of CT; however, adjuvant RT demonstrates benefit in patients with locally resectable ESOS.
KW - Chemotherapy
KW - Extraskeletal osteosarcoma
KW - Radiation therapy
KW - Radiotherapy
KW - Soft-tissue osteosarcoma
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U2 - 10.1016/j.ejca.2019.07.029
DO - 10.1016/j.ejca.2019.07.029
M3 - Article
C2 - 31806415
AN - SCOPUS:85076576201
SN - 0959-8049
VL - 125
SP - 130
EP - 141
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -