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Osteosarcoma in Asian Populations Over the Age of 40 Years: A Multicenter Study

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Elderly patients with osteosarcoma (OSA) are no longer uncommon; however, many questions remain regarding this population. We investigated the clinicopathological characteristics and prognostic factors of OSA in an Asian population over the age of 40 years.

Methods

This was a multi-national, multi-institutional study by the Eastern Asian Musculoskeletal Oncology Group (EAMOG).

Results

A total of 232 patients were enrolled (116 males and 116 females), with a median age of 50 years at diagnosis; 25 (10.8 %) patients exhibited initial metastasis. Median follow-up was 52 months for survivors. We observed 102 osteolytic and mixed radiographic findings for 173 lesions. Histological subtypes other than osteoblastic type were frequent. Radiation-associated OSA was seen in seven patients, with a 5-year overall survival (OS) of 16.7 %. No Paget’s OSA was observed. High-grade spinopelvic OSA was seen in 29 (12.5 %) patients. The 5-year OS was 59.4 % in patients without initial metastasis and 45.2 % in patients with spinopelvic OSA. While surgery and initial metastasis were common prognostic factors for OS, chemotherapy was not. Histologic response to neoadjuvant chemotherapy was poor in 61 of 83 patients.

Conclusion

This study revealed distinct clinicopathological features of OSA patients over 40 years of age compared with younger patients, such as the high incidence of axial tumors, common osteolytic and mixed radiographic findings, the high frequency of unusual histologic subtypes, and poor prognosis. Contrary to Western elderly patients with OSA, there was no Paget’s OSA in this study, which may result in a lower incidence of secondary OSA. Prognostic factor analyses demonstrated chemotherapy did not influence OS.

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Acknowledgments

Funding for this study was kindly provided by Seoul St. Mary’s Clinical Medicine Research Program through the Catholic University of Korea.

Disclosure

Min Wook Joo, Seung Han Shin, Yong-Koo Kang, Akira Kawai, Han Soo Kim, Apichat Asavamongkolkul, Dae-Geun Jeon, Jae Do Kim, Xiaohui Niu, Hiroyuki Tsuchiya, Ajay Puri, Edward H.M. Wang, So Hak Chung, and Yang-Guk Chung declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon-si, Gyeonggi-do, Republic of Korea

    Min Wook Joo MD & Yong-Koo Kang MD, PhD

  2. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Seung Han Shin MD, PhD & Yang-Guk Chung MD, PhD

  3. Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan

    Akira Kawai MD, PhD

  4. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea

    Han Soo Kim MD, PhD

  5. Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Apichat Asavamongkolkul MD

  6. Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea

    Dae-Geun Jeon MD, PhD

  7. Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea

    Jae Do Kim MD, PhD & So Hak Chung MD, PhD

  8. Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Beijing, China

    Xiaohui Niu MD, PhD

  9. Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan

    Hiroyuki Tsuchiya MD, PhD

  10. Department of Orthopaedic Oncology, Tata Memorial Hospital, Mumbai, India

    Ajay Puri MS

  11. Tumor Service, Department of Orthopedics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

    Edward H. M. Wang MD, PhD

Authors
  1. Min Wook Joo MD
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  2. Seung Han Shin MD, PhD
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  3. Yong-Koo Kang MD, PhD
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  4. Akira Kawai MD, PhD
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  5. Han Soo Kim MD, PhD
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  6. Apichat Asavamongkolkul MD
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  7. Dae-Geun Jeon MD, PhD
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  8. Jae Do Kim MD, PhD
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  9. Xiaohui Niu MD, PhD
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  10. Hiroyuki Tsuchiya MD, PhD
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  11. Ajay Puri MS
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  12. Edward H. M. Wang MD, PhD
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  13. So Hak Chung MD, PhD
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  14. Yang-Guk Chung MD, PhD
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Corresponding author

Correspondence to Yang-Guk Chung MD, PhD.

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Joo, M.W., Shin, S.H., Kang, YK. et al. Osteosarcoma in Asian Populations Over the Age of 40 Years: A Multicenter Study. Ann Surg Oncol 22, 3557–3564 (2015). https://doi.org/10.1245/s10434-015-4414-6

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  • DOI: https://doi.org/10.1245/s10434-015-4414-6

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