Survival after osteosarcoma recurrence still poor

Although as many as 70% of patients with localized osteosarcoma may survive following primary surgery and chemotherapy, the overall survival after recurrence is less than 30%, researchers report.

However, lead investigator Dr. Paul A. Meyers told Reuters Health, “the chances of survival are better for patients whose recurrence is detected after a longer interval from the completion of initial therapy and for patients whose recurrence is limited to fewer sites.”Dr. Meyers of Memorial Sloan-Kettering Cancer Center and colleagues retrospectively examined data on patients who achieved complete remission and those who were treated for a first recurrence at that institution after 1990.Of 43 eligible patients, the median time from diagnosis to recurrence was 21.7 months, the team reports in the November issue of Cancer. Recurrence was in the lungs in 33 of the patients. At a median follow-up of 15 months, only 15 (35%) of the patients were still alive.None of the 8 patients who received chemotherapy alone survived, while 3 of the 4 who received surgery alone survived. Of the 31 treated with surgery and chemotherapy, 22 achieved a second complete remission. Of these patients, 9 (29%) were alive and in remission at the time of the last follow-up.Thus, commented Dr. Meyers, “cure is never seen without complete surgical resection of all sites of clinically detectable metastatic disease.””The probability for long-term disease free survival,” he added, “may be enhanced by the use of high dose ifosfamide as an adjuvant to surgical resection.” However, he and his colleagues conclude, “In the end, the role of chemotherapy in recurrent osteosarcoma continues to remain undefined.”(Source: Cancer 2005;104:2214-2221: Reuters Health: Oncolink: December 2005.)