Int J Cancer. 2021 Sep 25. doi: 10.1002/ijc.33823. Online ahead of print.
ABSTRACT
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; > 5 metastases, time to 1st metastases < 24 months, were statistically significant negative prognostic factors for OS and PFS (p= 0.002, ≤0.001 and p=0.006, ≤0.001 respectively). Surgery of metastases was associated with better prognosis on OS and PFS (p=0.001 and 0.037 respectively). The presence of bone metastases was a negative prognostic factor on OS but not on PFS (p=0.021). In reference sarcoma centers, relapsed osteosarcoma patients with > 1 metastasis commonly receive more than one line of systemic therapy, and are included in clinical trial if available. This article is protected by copyright. All rights reserved.
PMID:34562271 | DOI:10.1002/ijc.33823
