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Annals of Oncology Advance Access published online on January 19, 2009
Annals of Oncology, doi:10.1093/annonc/mdn731
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Osteosarcoma in adolescents and adults: survival analysis with and without lung metastases

A. H. Aljubran1,*, A. Griffin2, M. Pintilie3 and M. Blackstein4

1 Department of Medical Oncology, King Faisal Cancer Center, Riyadh, Saudi Arabia
2 Department of Orthopedics, Mount Sinai Hospital
3 Department of Biostatistics, Princess Margaret Hospital
4 Department of Medical Oncology, Mount Sinai Hospital, Toronto, Canada

* Correspondence to: Dr A. H. Aljubran, King Faisal Hospital and Research Center, King Faisal Cancer Center, MBC 64, PO Box 3354, Riyadh 11211, Saudi Arabia. Tel: +966-1-442-3935; Fax: +966-1-442-3941; E-mail: ajubran{at}kfshrc.edu.sa

Background: Survival data are still limited and controversial about adult patients with osteosarcoma as older group of patients has mostly been excluded from the historical trials.

Patients and methods: Patients with osteosarcoma, from 1986 to 2003, in a single center, were reviewed. Survival according to a cutoff age of 40 was studied. Patients with lung metastases were identified. Variables at first lung involvement including time to first lung metastases, multiplicity and size of the metastatic lesions and use of chemotherapy were all analyzed.

Results: A total of 247 patients, with age range of 14–77 years, were reviewed. Five-year survival is 66% with no difference between patients <40 or ≥40 years. Eighty-five patients, with either synchronous or metachronous lung involvement, have 3-year postlung metastases survival (PLMS) of 30%. Forty-seven patients (55.3%) underwent lung resection with 3-year PLMS of 38% compared with 16% for nonoperated patients (P = 0.00023). Patients who developed lung metastases within a year and have fewer than four lung lesions have better PLMS (P < 0.0001 for both).

Conclusions: Older patients have identical survival to pediatric population and should have a similar management approach. Complete metastectomy is the key issue for prolonged survival. Time to lung metastases and number of lung lesions are the most important prognostic factors.

adult patients, lung metastasis, osteosarcoma, survival

Received for publication August 11, 2008. Revision received November 2, 2008. Accepted for publication November 3, 2008.


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