Treatment of 120 adult osteosarcoma patients with metachronous and synchronous metastases: a retrospective series of the French Sarcoma Group.
Fiche publication
Date publication
septembre 2021
Journal
International journal of cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr KURTZ Jean-Emmanuel
Tous les auteurs :
Lavit E, Aldea M, Piperno-Neumann S, Firmin N, Italiano A, Isambert N, Kurtz JE, Delcambre C, Lebrun V, Soibinet-Oudot P, Chevreau C, Bompas E, Le Maignan C, Boudou-Rouquette P, Le Cesne A, Mancini J, Blay JY, Duffaud F
Lien Pubmed
Résumé
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 1 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.
Mots clés
metastatic osteosarcomas, prognosis, treatment
Référence
Int J Cancer. 2021 Sep 25;: