TY - JOUR
T1 - De novo osteogenic sarcoma in patients older than forty
T2 - Benefit of multimodality therapy
AU - Manoso, Mark W.
AU - Healey, John H.
AU - Boland, Patrick J.
AU - Athanasian, Edward A.
AU - Maki, Robert G.
AU - Huvos, Andrew G.
AU - Morris, Carol D.
PY - 2005/9
Y1 - 2005/9
N2 - The treatment of primary osteogenic sarcoma is well established in younger patients; however, controversy surrounds the treatment of this disease in the older population. To confirm multimodality therapy results in longer survival than surgery alone, 58 patients older than 40 years with primary osteogenic sarcoma were assessed retrospectively for the benefits of multimodality treatment versus surgery alone. We then asked whether specific patient and tumor characteristics and treatment modalities affected the rates of survival. Finally, we questioned whether pulmonary metastatectomy increased survival. The 5-year and 10-year overall survival for the group was 58% and 44%, respectively. Multimodality therapy increased survival compared with surgery alone in patients with high-grade disease. On multivariate analysis, considerable prognostic factors for improved overall survival for the entire group were age younger than 60 years, volume less than 100 cm3, normal alkaline phosphatase, localized disease, negative surgical margins, and absence of recurrence. Pulmonary metastatectomy improved survival in selected patients. Level of Evidence: Therapeutic study, Level III-1 (retrospective cohort study).
AB - The treatment of primary osteogenic sarcoma is well established in younger patients; however, controversy surrounds the treatment of this disease in the older population. To confirm multimodality therapy results in longer survival than surgery alone, 58 patients older than 40 years with primary osteogenic sarcoma were assessed retrospectively for the benefits of multimodality treatment versus surgery alone. We then asked whether specific patient and tumor characteristics and treatment modalities affected the rates of survival. Finally, we questioned whether pulmonary metastatectomy increased survival. The 5-year and 10-year overall survival for the group was 58% and 44%, respectively. Multimodality therapy increased survival compared with surgery alone in patients with high-grade disease. On multivariate analysis, considerable prognostic factors for improved overall survival for the entire group were age younger than 60 years, volume less than 100 cm3, normal alkaline phosphatase, localized disease, negative surgical margins, and absence of recurrence. Pulmonary metastatectomy improved survival in selected patients. Level of Evidence: Therapeutic study, Level III-1 (retrospective cohort study).
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U2 - 10.1097/01.blo.0000179587.42350.4d
DO - 10.1097/01.blo.0000179587.42350.4d
M3 - Article
C2 - 16131878
AN - SCOPUS:24344450593
SN - 0009-921X
VL - 438
SP - 110
EP - 115
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
ER -