A retrospective study of overall survival and metastasis-free survival of adults with osteosarcoma and comparison to pediatric treatment outcomes
Berk, Tucker Kaneharu
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Osteosarcoma is a rare osteogenic cancer which is a predominantly pediatric/young adult disease but has a large adult population. Due to the skewed patient population, randomized clinical trials have focused on the younger osteosarcoma cases, and then applying these treatments to adults. Yet these treatments have not been tested in a prospective randomized clinical trial for adults for whether they achieve the same outcomes as those in the pediatric population. The purpose of this study is to compare outcomes of pediatric and adult osteosarcoma cases through a retrospective review of patients treated at two facilities, Dana-Farber Cancer Institute (DFCI) and Massachusetts General Hospital (MGH). A list of 2,263 potential patients was provided by the pathology departments of DFCI/MGH. Eligibility required: 1) the patient to be at least 18 YO at the time of diagnosis, 2) a pathology report confirming osteosarcoma, 3) the available follow-up data is greater than 1 year (unless the patient died within that year). The electronic charts were assessed for prognostic variables which includes; date of diagnosis, age at diagnosis, sex, primary disease site, tumor size, histologic response, and treatment course. The overall survival and metastasis free survival were based on the date of pathologic confirmation of osteosarcoma. The collected data was analyzed through the Kaplan-Meier method to produce overall survival and metastasis free survival curves. The 5-year OS and MFS rates were calculated with those alive at last follow-up censored from the analysis. The prognostic variables were tested for significant difference in OS and MFS by ANOVA and t-tests. Of potential patients, 177 were deemed eligible for this study and were found to have 5-year MFS and OS of 45.8% and 64.4%, respectively. When compared against results from a primarily pediatric/young adult study, our patient population had a significantly lower OS and MFS. This finding indicates that current treatment regimens have a shorter effect in adult osteosarcoma cases when compared to pediatric patients. Although pediatric patients have a sustained response to current treatment therapies, the adult cases of osteosarcoma have a significantly shortened outcome which needs to be addressed in future research.
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