Osteosarcoma of the pelvis: Experience of the Cooperative Osteosarcoma Study Group

Toshihumi Ozaki, Silke Flege, Matthias Kevric, Norbert Lindner, Rainer Maas, Günter Delling, Rudolf Schwarz, Arthur R. Von Hochstetter, Mechthild Salzer-Kuntschik, Wolfgang E. Berdel, Heribert Jürgens, G. Ulrich Exner, Peter Reichardt, Regine Mayer-Steinacker, Volker Ewerbeck, Rainer Kotz, Winfried Winkelmann, Stefan S. Bielack

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Abstract

Purpose: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. Results: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P <.0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P <.0001), and no radiotherapy (RR = 4.196; P = .0059) were independent poor prognostic factors. Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

Original languageEnglish
Pages (from-to)334-341
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number2
DOIs
Publication statusPublished - Jan 15 2003

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Osteosarcoma
Pelvis
Radiotherapy
Neoplasm Metastasis
Survival
Neoplasms
Hemipelvectomy
Disease-Free Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ozaki, T., Flege, S., Kevric, M., Lindner, N., Maas, R., Delling, G., ... Bielack, S. S. (2003). Osteosarcoma of the pelvis: Experience of the Cooperative Osteosarcoma Study Group. Journal of Clinical Oncology, 21(2), 334-341. https://doi.org/10.1200/JCO.2003.01.142

Osteosarcoma of the pelvis : Experience of the Cooperative Osteosarcoma Study Group. / Ozaki, Toshihumi; Flege, Silke; Kevric, Matthias; Lindner, Norbert; Maas, Rainer; Delling, Günter; Schwarz, Rudolf; Von Hochstetter, Arthur R.; Salzer-Kuntschik, Mechthild; Berdel, Wolfgang E.; Jürgens, Heribert; Exner, G. Ulrich; Reichardt, Peter; Mayer-Steinacker, Regine; Ewerbeck, Volker; Kotz, Rainer; Winkelmann, Winfried; Bielack, Stefan S.

In: Journal of Clinical Oncology, Vol. 21, No. 2, 15.01.2003, p. 334-341.

Research output: Contribution to journalArticle

Ozaki, T, Flege, S, Kevric, M, Lindner, N, Maas, R, Delling, G, Schwarz, R, Von Hochstetter, AR, Salzer-Kuntschik, M, Berdel, WE, Jürgens, H, Exner, GU, Reichardt, P, Mayer-Steinacker, R, Ewerbeck, V, Kotz, R, Winkelmann, W & Bielack, SS 2003, 'Osteosarcoma of the pelvis: Experience of the Cooperative Osteosarcoma Study Group', Journal of Clinical Oncology, vol. 21, no. 2, pp. 334-341. https://doi.org/10.1200/JCO.2003.01.142
Ozaki, Toshihumi ; Flege, Silke ; Kevric, Matthias ; Lindner, Norbert ; Maas, Rainer ; Delling, Günter ; Schwarz, Rudolf ; Von Hochstetter, Arthur R. ; Salzer-Kuntschik, Mechthild ; Berdel, Wolfgang E. ; Jürgens, Heribert ; Exner, G. Ulrich ; Reichardt, Peter ; Mayer-Steinacker, Regine ; Ewerbeck, Volker ; Kotz, Rainer ; Winkelmann, Winfried ; Bielack, Stefan S. / Osteosarcoma of the pelvis : Experience of the Cooperative Osteosarcoma Study Group. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 2. pp. 334-341.
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abstract = "Purpose: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. Results: Local failure occurred in 47 of all 67 patients (70{\%}) and in 31 of 50 patients (62{\%}) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27{\%} and 19{\%}, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P <.0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P <.0001), and no radiotherapy (RR = 4.196; P = .0059) were independent poor prognostic factors. Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.",
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T2 - Experience of the Cooperative Osteosarcoma Study Group

AU - Ozaki, Toshihumi

AU - Flege, Silke

AU - Kevric, Matthias

AU - Lindner, Norbert

AU - Maas, Rainer

AU - Delling, Günter

AU - Schwarz, Rudolf

AU - Von Hochstetter, Arthur R.

AU - Salzer-Kuntschik, Mechthild

AU - Berdel, Wolfgang E.

AU - Jürgens, Heribert

AU - Exner, G. Ulrich

AU - Reichardt, Peter

AU - Mayer-Steinacker, Regine

AU - Ewerbeck, Volker

AU - Kotz, Rainer

AU - Winkelmann, Winfried

AU - Bielack, Stefan S.

PY - 2003/1/15

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N2 - Purpose: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. Results: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P <.0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P <.0001), and no radiotherapy (RR = 4.196; P = .0059) were independent poor prognostic factors. Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

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