Osteosarcoma in patients over 50 years of age: Multi-institutional retrospective analysis of 104 patients

Akihito Nagano, Seiichi Matsumoto, Akira Kawai, Tomotake Okuma, Hiroaki Hiraga, Yoshihiro Matsumoto, Yoshihiro Nishida, Tsukasa Yonemoto, Masami Hosaka, Mitsuru Takahashi, Hideki Yoshikawa, Toshiyuki Kunisada, Kunihiro Asanuma, Norifumi Naka, Makoto Emori, Tadahiko Kubo, Hiroyuki Kawashima, Teruya Kawamoto, Ryohei Yokoyama, Satoshi TsukushiKenji Sato, Takeshi Okamoto, Koji Hiraoka, Hideo Morioka, Kazuhiro Tanaka, Tatsuya Takagi, Yukihide Iwamoto, Toshifumi Ozaki

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Abstract

Background: Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. Methods: This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. Results: Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8%) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6% and 71.7%, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2% and 43.6%, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. Conclusions: The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.

Original languageEnglish
JournalJournal of Orthopaedic Science
DOIs
Publication statusPublished - Jan 1 2019

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Osteosarcoma
Drug Therapy
Adjuvant Chemotherapy
Survival
Survival Rate
Recurrence
Medical Oncology
Neoplasms
Japan
Retrospective Studies
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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Osteosarcoma in patients over 50 years of age : Multi-institutional retrospective analysis of 104 patients. / Nagano, Akihito; Matsumoto, Seiichi; Kawai, Akira; Okuma, Tomotake; Hiraga, Hiroaki; Matsumoto, Yoshihiro; Nishida, Yoshihiro; Yonemoto, Tsukasa; Hosaka, Masami; Takahashi, Mitsuru; Yoshikawa, Hideki; Kunisada, Toshiyuki; Asanuma, Kunihiro; Naka, Norifumi; Emori, Makoto; Kubo, Tadahiko; Kawashima, Hiroyuki; Kawamoto, Teruya; Yokoyama, Ryohei; Tsukushi, Satoshi; Sato, Kenji; Okamoto, Takeshi; Hiraoka, Koji; Morioka, Hideo; Tanaka, Kazuhiro; Takagi, Tatsuya; Iwamoto, Yukihide; Ozaki, Toshifumi.

In: Journal of Orthopaedic Science, 01.01.2019.

Research output: Contribution to journalArticle

Nagano, A, Matsumoto, S, Kawai, A, Okuma, T, Hiraga, H, Matsumoto, Y, Nishida, Y, Yonemoto, T, Hosaka, M, Takahashi, M, Yoshikawa, H, Kunisada, T, Asanuma, K, Naka, N, Emori, M, Kubo, T, Kawashima, H, Kawamoto, T, Yokoyama, R, Tsukushi, S, Sato, K, Okamoto, T, Hiraoka, K, Morioka, H, Tanaka, K, Takagi, T, Iwamoto, Y & Ozaki, T 2019, 'Osteosarcoma in patients over 50 years of age: Multi-institutional retrospective analysis of 104 patients', Journal of Orthopaedic Science. https://doi.org/10.1016/j.jos.2019.04.008
Nagano, Akihito ; Matsumoto, Seiichi ; Kawai, Akira ; Okuma, Tomotake ; Hiraga, Hiroaki ; Matsumoto, Yoshihiro ; Nishida, Yoshihiro ; Yonemoto, Tsukasa ; Hosaka, Masami ; Takahashi, Mitsuru ; Yoshikawa, Hideki ; Kunisada, Toshiyuki ; Asanuma, Kunihiro ; Naka, Norifumi ; Emori, Makoto ; Kubo, Tadahiko ; Kawashima, Hiroyuki ; Kawamoto, Teruya ; Yokoyama, Ryohei ; Tsukushi, Satoshi ; Sato, Kenji ; Okamoto, Takeshi ; Hiraoka, Koji ; Morioka, Hideo ; Tanaka, Kazuhiro ; Takagi, Tatsuya ; Iwamoto, Yukihide ; Ozaki, Toshifumi. / Osteosarcoma in patients over 50 years of age : Multi-institutional retrospective analysis of 104 patients. In: Journal of Orthopaedic Science. 2019.
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abstract = "Background: Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. Methods: This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. Results: Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8{\%}) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6{\%} and 71.7{\%}, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2{\%} and 43.6{\%}, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. Conclusions: The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.",
author = "Akihito Nagano and Seiichi Matsumoto and Akira Kawai and Tomotake Okuma and Hiroaki Hiraga and Yoshihiro Matsumoto and Yoshihiro Nishida and Tsukasa Yonemoto and Masami Hosaka and Mitsuru Takahashi and Hideki Yoshikawa and Toshiyuki Kunisada and Kunihiro Asanuma and Norifumi Naka and Makoto Emori and Tadahiko Kubo and Hiroyuki Kawashima and Teruya Kawamoto and Ryohei Yokoyama and Satoshi Tsukushi and Kenji Sato and Takeshi Okamoto and Koji Hiraoka and Hideo Morioka and Kazuhiro Tanaka and Tatsuya Takagi and Yukihide Iwamoto and Toshifumi Ozaki",
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T1 - Osteosarcoma in patients over 50 years of age

T2 - Multi-institutional retrospective analysis of 104 patients

AU - Nagano, Akihito

AU - Matsumoto, Seiichi

AU - Kawai, Akira

AU - Okuma, Tomotake

AU - Hiraga, Hiroaki

AU - Matsumoto, Yoshihiro

AU - Nishida, Yoshihiro

AU - Yonemoto, Tsukasa

AU - Hosaka, Masami

AU - Takahashi, Mitsuru

AU - Yoshikawa, Hideki

AU - Kunisada, Toshiyuki

AU - Asanuma, Kunihiro

AU - Naka, Norifumi

AU - Emori, Makoto

AU - Kubo, Tadahiko

AU - Kawashima, Hiroyuki

AU - Kawamoto, Teruya

AU - Yokoyama, Ryohei

AU - Tsukushi, Satoshi

AU - Sato, Kenji

AU - Okamoto, Takeshi

AU - Hiraoka, Koji

AU - Morioka, Hideo

AU - Tanaka, Kazuhiro

AU - Takagi, Tatsuya

AU - Iwamoto, Yukihide

AU - Ozaki, Toshifumi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. Methods: This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. Results: Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8%) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6% and 71.7%, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2% and 43.6%, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. Conclusions: The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.

AB - Background: Primary osteosarcoma in elderly patients are rare malignant tumors. Its optimal treatment has not yet been determined. Methods: This retrospective study included 104 patients aged >50 years with resectable, non-metastatic osteosarcoma treated by the members of the Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group. The effects of adjuvant chemotherapy were estimated by comparing outcomes in patients who received surgery plus chemotherapy with those who underwent surgery alone. Results: Median age at presentation was 59 years. Neoadjuvant and adjuvant chemotherapy was administered to 83 (79.8%) patients. Patients who underwent surgery plus chemotherapy and those who underwent surgery alone had 5-year overall survival (OS) rates of 68.6% and 71.7%, respectively (p = 0.780), and 5-year relapse free survival (RFS) rates of 48.2% and 43.6%, respectively (p = 0.64). Univariate analysis showed that resection with wide margins was significantly correlated with better prognosis. Conclusions: The addition of chemotherapy to surgery did not improve OS or RFS in patients aged >50 years with resectable, non-metastatic osteosarcoma. Surgery with wide margins was only significantly prognostic of improved survival. The effect of chemotherapy in elderly osteosarcoma patients was unclear.

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DO - 10.1016/j.jos.2019.04.008

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JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

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