What has changed in the last 25 years in osteosarcoma treatment? A single center experience

Background. Osteosarcoma is the most common type of primary malignant bone tumor in the extremities. The main purpose of this study was to determine clinical features, prognostic factors, and treatment results of patients with osteosarcoma at our center. Methods. We retrospectively ana...

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Main Authors: Eda Ataseven, Zeynep Burak, Dündar Sabah, Başak Doğanavşargil, Mehmet Argın, Burçin Keçeci, İpek Tamsel, Hüseyin Kaya, Şebnem Önen Göktepe, Mehmet Kantar
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2023-02-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/7
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author Eda Ataseven
Zeynep Burak
Dündar Sabah
Başak Doğanavşargil
Mehmet Argın
Burçin Keçeci
İpek Tamsel
Hüseyin Kaya
Şebnem Önen Göktepe
Mehmet Kantar
author_facet Eda Ataseven
Zeynep Burak
Dündar Sabah
Başak Doğanavşargil
Mehmet Argın
Burçin Keçeci
İpek Tamsel
Hüseyin Kaya
Şebnem Önen Göktepe
Mehmet Kantar
author_sort Eda Ataseven
collection DOAJ
description Background. Osteosarcoma is the most common type of primary malignant bone tumor in the extremities. The main purpose of this study was to determine clinical features, prognostic factors, and treatment results of patients with osteosarcoma at our center. Methods. We retrospectively analyzed the medical records of children with osteosarcoma between the years 1994-2020. Results. 79 patients were identified (54.4% male, 45.6% female). The most common primary site was the femur (62%). Twenty-six of them (32.9%) had lung metastasis at diagnosis. The patients were treated between 1995- 2013 according to the Mayo Pilot II Study protocol, while the others were treated with the EURAMOS protocol between the years 2013-2020. Sixty-nine patients underwent limb salvage surgery as a local treatment, whereas seven underwent amputation. The median follow-up time was 53 months (2.5-265 months). The event-free survival (EFS) and overall survival (OS) rates at 5 years were 52.1% and 61.5%. The 5-year EFS and OS rates were 69.4% and 80% in females; 37.1% and 45.5% in males (p=0.008/p=0.001). The 5-year EFS and OS rates of the patients without metastasis were 63.2% and 66.3%; with metastasis 28.8% and 51.8% (p=0.002/p=0.05). For good-responders, the 5-year EFS and OS rates were 80.2% and 89.1%; while for poor-responders, 35% and 46.7% (p=0.001). Mifamurtide was used in addition to chemotherapy as of the year 2016 (n=16). The 5-year EFS and OS rates were 78.8% and 91.7%, respectively for the mifamurtide group; 55.1% and 45.9%, respectively for the non-mifamurtide group (p=0.015, p=0.027). Conclusions. Metastasis at diagnosis and poor response to preoperative chemotherapy were the most important predictors of survival. Females had a better outcome than males. In our study group, the mifamurtide group`s survival rates were significantly higher. Further large studies are needed to validate the efficacy of mifamurtide.
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publisher Hacettepe University Institute of Child Health
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series The Turkish Journal of Pediatrics
spelling doaj-art-6d2fb63c2d2f424a89ec4aefd2ecbd0e2025-08-20T02:17:50ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212023-02-0165110.24953/turkjped.2022.463What has changed in the last 25 years in osteosarcoma treatment? A single center experienceEda Ataseven0Zeynep Burak1Dündar Sabah2Başak Doğanavşargil3Mehmet Argın4Burçin Keçeci5İpek Tamsel6Hüseyin Kaya7Şebnem Önen Göktepe8Mehmet Kantar9Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ege University School of Medicine, İzmir.Department of Nuclear Medicine, Ege University School of Medicine, İzmir, Türkiye.Department of Orthopedics and Traumatology, Ege University School of Medicine, İzmir.Department of Pathology, Ege University School of Medicine İzmir.Department of Radiology, Ege University School of Medicine, İzmir.Department of Orthopedics and Traumatology, Ege University School of Medicine, İzmir.Department of Radiology, Ege University School of Medicine, İzmir.Department of Orthopedics and Traumatology, Ege University School of Medicine, İzmir.Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ege University School of Medicine, İzmir.Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ege University School of Medicine, İzmir. Background. Osteosarcoma is the most common type of primary malignant bone tumor in the extremities. The main purpose of this study was to determine clinical features, prognostic factors, and treatment results of patients with osteosarcoma at our center. Methods. We retrospectively analyzed the medical records of children with osteosarcoma between the years 1994-2020. Results. 79 patients were identified (54.4% male, 45.6% female). The most common primary site was the femur (62%). Twenty-six of them (32.9%) had lung metastasis at diagnosis. The patients were treated between 1995- 2013 according to the Mayo Pilot II Study protocol, while the others were treated with the EURAMOS protocol between the years 2013-2020. Sixty-nine patients underwent limb salvage surgery as a local treatment, whereas seven underwent amputation. The median follow-up time was 53 months (2.5-265 months). The event-free survival (EFS) and overall survival (OS) rates at 5 years were 52.1% and 61.5%. The 5-year EFS and OS rates were 69.4% and 80% in females; 37.1% and 45.5% in males (p=0.008/p=0.001). The 5-year EFS and OS rates of the patients without metastasis were 63.2% and 66.3%; with metastasis 28.8% and 51.8% (p=0.002/p=0.05). For good-responders, the 5-year EFS and OS rates were 80.2% and 89.1%; while for poor-responders, 35% and 46.7% (p=0.001). Mifamurtide was used in addition to chemotherapy as of the year 2016 (n=16). The 5-year EFS and OS rates were 78.8% and 91.7%, respectively for the mifamurtide group; 55.1% and 45.9%, respectively for the non-mifamurtide group (p=0.015, p=0.027). Conclusions. Metastasis at diagnosis and poor response to preoperative chemotherapy were the most important predictors of survival. Females had a better outcome than males. In our study group, the mifamurtide group`s survival rates were significantly higher. Further large studies are needed to validate the efficacy of mifamurtide. https://turkjpediatr.org/article/view/7chemotherapychildhoodosteosarcomasurgerytreatment
spellingShingle Eda Ataseven
Zeynep Burak
Dündar Sabah
Başak Doğanavşargil
Mehmet Argın
Burçin Keçeci
İpek Tamsel
Hüseyin Kaya
Şebnem Önen Göktepe
Mehmet Kantar
What has changed in the last 25 years in osteosarcoma treatment? A single center experience
The Turkish Journal of Pediatrics
chemotherapy
childhood
osteosarcoma
surgery
treatment
title What has changed in the last 25 years in osteosarcoma treatment? A single center experience
title_full What has changed in the last 25 years in osteosarcoma treatment? A single center experience
title_fullStr What has changed in the last 25 years in osteosarcoma treatment? A single center experience
title_full_unstemmed What has changed in the last 25 years in osteosarcoma treatment? A single center experience
title_short What has changed in the last 25 years in osteosarcoma treatment? A single center experience
title_sort what has changed in the last 25 years in osteosarcoma treatment a single center experience
topic chemotherapy
childhood
osteosarcoma
surgery
treatment
url https://turkjpediatr.org/article/view/7
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