Abstract
The survival of patients with osteosarcoma has improved dramatically due to the introduction of effective systemic chemotherapy. The key standard drugs for osteosarcoma chemotherapy are methotrexate, doxorubicin, and cisplatin, and multi-institutional trials based on these drugs have been conducted in Japan since the 1990s. However, there have been no nationwide data on treatment outcome, especially with regard to survival and prognostic factors. In this chapter, therefore, we present data from a large nationwide cohort of patients with osteosarcoma treated at 11 referral centers in Japan during the period 1990–2010 with special reference to survival and relevant prognostic factors. The 3-, 5-, and 10-year metastasis-free survival and overall survival rates for the 529 patients were 70 %, 64 %, and 62 % and 88 %, 83 %, and 77 %, respectively. The prognosis for patients with osteosarcoma in Japan was comparable to, or slightly better than, those reported in other countries. International collaboration should also be conducted in Asian countries including Japan to improve the outcome further and find the optimal treatment for osteosarcoma.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rosen G, Marcove RC, Huvos AG, Caparros BI, Lane JM, Nirenberg A, et al. Primary osteogenic sarcoma: eight-year experience with adjuvant chemotherapy. J Cancer Res Clin Oncol. 1983;106(Suppl):55–67.
Eilber F, Giuliano A, Eckardt J, Patterson K, Moseley S, Goodnight J. Adjuvant chemotherapy for osteosarcoma: a randomized prospective trial. J Clin Oncol. 1987;5(1):21–6.
Link MP, Goorin AM, Miser AW, Green AA, Pratt CB, Belasco JB, et al. The effect of adjuvant chemotherapy on relapse-free survival in patients with osteosarcoma of the extremity. N Engl J Med. 1986;314(25):1600–6. doi:10.1056/NEJM198606193142502.
Link MP, Goorin AM, Horowitz M, Meyer WH, Belasco J, Baker A, et al. Adjuvant chemotherapy of high-grade osteosarcoma of the extremity. Updated results of the multi-institutional osteosarcoma study. Clin Orthop Relat Res. 1991;270:8–14.
Meyers PA, Schwartz CL, Krailo M, Kleinerman ES, Betcher D, Bernstein ML, et al. Osteosarcoma: a randomized, prospective trial of the addition of ifosfamide and/or muramyl tripeptide to cisplatin, doxorubicin, and high-dose methotrexate. J Clin Oncol. 2005;23(9):2004–11. doi:10.1200/JCO.2005.06.031.
Harris MB, Cantor AB, Goorin AM, Shochat SJ, Ayala AG, Ferguson WS, et al. Treatment of osteosarcoma with ifosfamide: comparison of response in pediatric patients with recurrent disease versus patients previously untreated: a Pediatric Oncology Group study. Med Pediatr Oncol. 1995;24(2):87–92.
Goorin AM, Schwartzentruber DJ, Devidas M, Gebhardt MC, Ayala AG, Harris MB, et al. Presurgical chemotherapy compared with immediate surgery and adjuvant chemotherapy for nonmetastatic osteosarcoma: Pediatric Oncology Group Study POG-8651. J Clin Oncol. 2003;21(8):1574–80. doi:10.1200/JCO.2003.08.165.
Bacci G, Bertoni F, Longhi A, Ferrari S, Forni C, Biagini R, et al. Neoadjuvant chemotherapy for high-grade central osteosarcoma of the extremity. Histologic response to preoperative chemotherapy correlates with histologic subtype of the tumor. Cancer. 2003;97(12):3068–75. doi:10.1002/cncr.11456.
Patel SJ, Lynch Jr JW, Johnson T, Carroll RR, Schumacher C, Spanier S, et al. Dose-intense ifosfamide/doxorubicin/cisplatin based chemotherapy for osteosarcoma in adults. Am J Clin Oncol. 2002;25(5):489–95.
Wilkins RM, Cullen JW, Odom L, Jamroz BA, Cullen PM, Fink K, et al. Superior survival in treatment of primary nonmetastatic pediatric osteosarcoma of the extremity. Ann Surg Oncol. 2003;10(5):498–507.
Bielack SS, Kempf-Bielack B, Delling G, Exner GU, Flege S, Helmke K, 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(3):776–90.
Crews KR, Liu T, Rodriguez-Galindo C, Tan M, Meyer WH, Panetta JC, et al. High-dose methotrexate pharmacokinetics and outcome of children and young adults with osteosarcoma. Cancer. 2004;100(8):1724–33. doi:10.1002/cncr.20152.
Iwamoto Y, Tanaka K, Isu K, Kawai A, Tatezaki S, Ishii T, et al. Multiinstitutional phase II study of neoadjuvant chemotherapy for osteosarcoma (NECO study) in Japan: NECO-93J and NECO-95J. J Orthop Sci. 2009;14(4):397–404. doi:10.1007/s00776-009-1347-6.
Iwamoto Y, Tanaka K. The activity of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. Jpn J Clin Oncol. 2012;42(6):467–70. doi:hys059 [pii] 10.1093/jjco/hys059 [doi].
Bacci G, Longhi A, Versari M, Mercuri M, Briccoli A, Picci P. Prognostic factors for osteosarcoma of the extremity treated with neoadjuvant chemotherapy: 15-year experience in 789 patients treated at a single institution. Cancer. 2006;106(5):1154–61. doi:10.1002/cncr.21724 [doi].
Grimer RJ, Taminiau AM, Cannon SR. Surgical outcomes in osteosarcoma. J Bone Joint Surg (Br). 2002;84(3):395–400.
Janeway KA, Barkauskas DA, Krailo MD, Meyers PA, Schwartz CL, Ebb DH, et al. Outcome for adolescent and young adult patients with osteosarcoma: a report from the Children’s Oncology Group. Cancer. 2012;118(18):4597–605. doi:10.1002/cncr.27414 [doi].
Kim MS, Lee SY, Lee TR, Cho WH, Song WS, Koh JS, et al. Prognostic nomogram for predicting the 5-year probability of developing metastasis after neo-adjuvant chemotherapy and definitive surgery for AJCC stage II extremity osteosarcoma. Ann Oncol. 2009;20(5):955–60. doi:mdn723 [pii] 10.1093/annonc/mdn723 [doi].
Smeland S, Muller C, Alvegard TA, Wiklund T, Wiebe T, Bjork O, et al. Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders. Eur J Cancer. 2003;39(4):488–94.
Bielack SS, Smeland S, Whelan JS, Marina N, Jovic G, Hook JM et al. Methotrexate, doxorubicin, and cisplatin (MAP) plus maintenance pegylated interferon alpha-2b versus MAP alone in patients with resectable high-grade osteosarcoma and good histologic response to preoperative MAP: first results of the EURAMOS-1 good response randomized controlled trial. J Clin Oncol. 2015;33(20):2279–87. doi:JCO.2014.60.0734 [pii] 10.1200/JCO.2014.60.0734 [doi].
Whelan JS, Bielack SS, Marina N, Smeland S, Jovic G, Hook JM et al. EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment. Ann Oncol. 2015;26(2):407–14. doi:mdu526 [pii] 10.1093/annonc/mdu526 [doi].
Acknowledgments
The authors would like to acknowledge Tsukasa Yonemoto, Shintaro Iwata, Hiroto Kamoda, and Yoko Hagiwara (Chiba Cancer Center); Tomohiro Fujiwara (Okayama University); Eiji Kozawa (Nagoya University); Shigeki Kakunaga (Osaka National Hospital); and Yusuke Shinoda and Yusuke Tsuda (The University of Tokyo Hospital) for data collection and kind assistance.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer Japan
About this chapter
Cite this chapter
Ogura, K. et al. (2016). Outcome of Treatment for Osteosarcoma of the Extremities Over the Last 20 Years: Report from 11 Referral Centers in Japan. In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_4
Download citation
DOI: https://doi.org/10.1007/978-4-431-55696-1_4
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-55695-4
Online ISBN: 978-4-431-55696-1
eBook Packages: MedicineMedicine (R0)