Skip to main content
SpringerLink
Log in

Comparison between preadolescent and adolescent patients with high-grade osteosarcoma in China

  • Published:
The Chinese-German Journal of Clinical Oncology

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Objective

The aim of this study was to assess the differences in clinical appearance and prognosis of osteosarcoma between preadolescent and adolescent in Chinese patients and investigate whether age at diagnosis is a prognostic indicator.

Methods

Between May 2002 and May 2009, ninety-six children with high-grade osteosarcoma treated at our institute were stratified according to the age of 10. There were 19 preadolescents (≤ 10 years) and 77 adolescents (10 years < age ≤ 19 years), and their medical records were reviewed and compared using Fisher exact tests. Overall survival and disease- free survival was estimated by Kaplan-Meier methods and compared using log-rank tests. The prognostic significance of the various factors on survival was examined by Cox regression analysis.

Results

There were no significant differences in terms of Karnofsky Performance Status (KPS) score, Enneking stage, tumor location, histologic type, pathologic fracture, tumor necrosis rate, tumor size, relapse and frequencies of adjuvant chemotherapy between the two groups. A high proportion of preadolescent patients was treated with amputation (78.9% vs. 44.2%; P = 0.01). The 5-year survival of the preadolescent and adolescent groups was (38 ± 14)% and (33 ± 10)%, and the 2-year disease free survival for each group was (45 ± 12)% and (44.4 ± 6.3)%, respectively. Our study showed that age did not have any statistical significance for survival (P = 0.803). Univariate analysis indicated that KPS score; frequencies of adjuvant chemotherapy, tumor size and relapse were significantly related to overall survival. Multivariate Cox regression analysis revealed that both frequencies of adjuvant chemotherapy and relapse were independently prognostic factors for survival.

Conclusion

Clinical characteristics and survival between the preadolescents and adolescents with osteosarcoma in China were compatible. So we suggested that there did not need to treat preadolescents patients by alternative and/ or aggressive therapies compared with adolescent patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nagarajan R, Weigel BJ, Thompson RC, et al. Osteosarcoma in the first decade of life. Med Pediatr Oncol, 2003, 41: 480–483.

    Article  PubMed  Google Scholar 

  2. Rytting M, Pearson P, Raymond AK, et al. Osteosarcoma in preadolescent patients. Clin Orthop Relat Res, 2000, 373: 39–50.

    Article  PubMed  Google Scholar 

  3. Bacci G, Longhi A, Bertoni F, et al. Primary high-grade osteosarcoma: comparison between preadolescent and older patients. J Pediatr Hematol Oncol, 2005, 27: 129–134.

    Article  PubMed  Google Scholar 

  4. Cho WH, Lee SY, Song WS, et al. Osteosarcoma in preadolescent patients. J Int Med Res, 2006, 34: 676–681.

    PubMed  CAS  Google Scholar 

  5. Bacci G, Balladelli A, Palmerini E, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremities in preadolescent patients: the Rizzoli Institute experience. J Pediatr Hematol Oncol, 2008, 30: 908–912.

    Article  PubMed  Google Scholar 

  6. Harting MT, Lally KP, Andrassy RJ, et al. Age as a prognostic factor for patients with osteosarcoma: an analysis of 438 patients. J Cancer Res Clin Oncol, 2010, 136: 561–570.

    Article  PubMed  Google Scholar 

  7. Hsieh MY, Hung GY, Yen HJ, et al. Osteosarcoma in preadolescent patients: experience in a single institute in Taiwan. J Chin Med Assoc, 2009, 72: 455–461.

    Article  PubMed  Google Scholar 

  8. Lee JA, Kim DH, Lim JS, et al. The survival of osteosarcoma patients 10 years old or younger is not worse than the survival of older patients: a retrospective analysis. Cancer Res Treat, 2007, 39: 160–164.

    Article  PubMed  Google Scholar 

  9. Bielack SS, Kempf-Bielack B, Delling G, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol, 2002, 20: 776–790.

    Article  PubMed  Google Scholar 

  10. Grimer RJ, Cannon SR, Taminiau AM, et al. Osteosarcoma over the age of forty. Eur J Cancer, 2003, 39: 157–163.

    Article  PubMed  CAS  Google Scholar 

  11. Kager L, Zoubek A, Pötschger U, et al. Primary metastatic osteosarcoma: presentation and outcome of patients treated on neoadjuvant Cooperative Osteosarcoma Study Group protocols. J Clin Oncol, 2003, 21: 2011–2018.

    Article  PubMed  Google Scholar 

  12. Scranton PE Jr, DeCicco FA, Totten RS, et al. Prognostic factors in osteosarcoma: A review of 20 years at the University of Pittsburg Health Center Hospitals. Cancer, 1975, 36: 2179–2191.

    Article  PubMed  Google Scholar 

  13. Winkler K, Beron G, Kotz R, et al. Neoadjuvant chemotherapy for osteogenic sarcoma: results of a Cooperative German/Austrian study. J Clin Oncol, 1984, 2: 617–624.

    PubMed  CAS  Google Scholar 

  14. French Bone Tumor Study Group. Age and dose of chemotherapy as major prognostic factors in a trial of adjuvant therapy of osteosarcoma combining two alternating drug combinations and early prophylactic lung irradiation. Cancer, 1988, 61: 1304–1311.

    Article  Google Scholar 

  15. Worch J, Matthay KK, Neuhaus J, et al. Osteosarcoma in children 5 years of age or younger at initial diagnosis. Pediatr Blood Cancer, 2010, 55: 285–289.

    Article  PubMed  Google Scholar 

  16. Picci P, Bacci G, Campanacci M, et al. Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy. Regional mapping of viable and nonviable tumor. Cancer, 1985, 56: 1515–1521.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, The Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, 200233, China

    Weixiang Qi, Zan Shen, Lina Tang, Aina He, Yumei Yang, Feng Lin & Yang Yao

Authors
  1. Weixiang Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zan Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lina Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aina He
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yumei Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Feng Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yang Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yang Yao.

Additional information

Supported by grants from the National Natural Science Foundation of China (No. of China (No. 81001191) and Science and Technology Commission of Shanghai (No. 10PJ1408300).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Qi, W., Shen, Z., Tang, L. et al. Comparison between preadolescent and adolescent patients with high-grade osteosarcoma in China. Chin. -Ger. J. Clin. Oncol. 11, 274–278 (2012). https://doi.org/10.1007/s10330-012-0965-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10330-012-0965-1

Key words

Search

Navigation