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Title: Osteosarcoma in Asian Populations Over the Age of 40 Years: A Multicenter Study
Authors: 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
Yang Guk Chung
The Catholic University of Korea
National Cancer Center Hospital
Seoul National University Hospital
Mahidol University
Korea Cancer Center Hospital
Kosin University
Beijing Ji Shui Tan Hospital
Kanazawa University
Tata Memorial Hospital
University of the Philippines Manila
Keywords: Medicine
Issue Date: 15-Oct-2015
Citation: Annals of Surgical Oncology. Vol.22, No.11 (2015), 3557-3564
Abstract: © 2015, Society of Surgical Oncology. 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.
ISSN: 15344681
Appears in Collections:Scopus 2011-2015

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