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Prognostic Factors in Elderly Osteosarcoma Patients: A Multi-institutional Retrospective Study of 86 Cases

Annals of Surgical Oncology volume 21, pages 263–268 (2014)Cite this article

Abstract

Background

The occurrence of osteosarcoma in elderly patients has recently been increasing, and the outcome is poor. This multi-institutional retrospective study was conducted to investigate clinical features and prognostic factors in patients older than 40 years with osteosarcoma.

Methods

Patients with conventional high-grade osteosarcoma older than 40 years were recruited to this study. Secondary osteosarcoma arising from Paget’s disease or irradiated bones was excluded. Information on tumor- and treatment-related factors was collected and statistically analyzed. The median follow-up was 57 months (range 8–244 months) for all surviving patients.

Results

A total of 86 patients were enrolled in this study. The median age at diagnosis was 61 years. Surgery and chemotherapy were conducted in 73 and 63 % of all patients, respectively. The 5-year overall and event-free survival rates were 38.8 and 34.0 %, respectively. Tumor site (extremity 57.9 %; axial 19.0 %; p < 0.0001), metastasis at diagnosis (yes 12.2 %; no 48.3 %; p < 0.0091), and definitive surgery (yes 56.2 %; no 10.6 %; p < 0.0001) were associated with overall survival. Although patients without metastasis who received definitive surgery were regarded as good candidates for chemotherapy, the addition of chemotherapy did not have any impact on the outcome (yes 63.4 %; no 65.2 %; p = 0.511).

Conclusions

The present study revealed the distinct clinical features, such as the high incidence of truncal tumors or metastasis at diagnosis, in patients older than 40 years with osteosarcoma. Additionally, prognostic factor analyses revealed that tumor site, metastasis at diagnosis, definitive surgery, and surgical margins were significant prognostic factors, whereas chemotherapy did not influence survival.

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Acknowledgment

We thank H. Chuman, F. Nakatani, A. Hosono, (National Cancer Center Hospital), and H. Kiuchi (Chiba Cancer Center) for collecting clinical information. We would also like to thank A. Araki (Chiba Cancer Center), A. Yoshida (National Cancer Center Hospital), and M. Takagi (St. Marianne University) for reviewing histological diagnoses.

Disclosure

The authors declare that they have no conflict of interest.

Funding

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Chiba Cancer Center, Chuo-ku, Chiba, Japan

    Shintaro Iwata MD, Takeshi Ishii MD, Tsukasa Yonemoto MD & Hiroto Kamoda MD

  2. Division of Orthopaedic Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan

    Akira Kawai MD & Naofumi Asano MD

  3. Division of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Yokohama, Japan

    Toru Hiruma MD & Masanobu Takeyama MD

Authors
  1. Shintaro Iwata MD
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  2. Takeshi Ishii MD
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  3. Akira Kawai MD
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  4. Toru Hiruma MD
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  5. Tsukasa Yonemoto MD
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  6. Hiroto Kamoda MD
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  7. Naofumi Asano MD
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  8. Masanobu Takeyama MD
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Correspondence to Shintaro Iwata MD.

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Iwata, S., Ishii, T., Kawai, A. et al. Prognostic Factors in Elderly Osteosarcoma Patients: A Multi-institutional Retrospective Study of 86 Cases. Ann Surg Oncol 21, 263–268 (2014). https://doi.org/10.1245/s10434-013-3210-4

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  • DOI: https://doi.org/10.1245/s10434-013-3210-4

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