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

Toshihumi Ozaki, Silke Flege, Ulf Liljenqvist, Axel Hillmann, Günter Delling, Mechthild Salzer-Kuntschik, Heribert Jürgens, Rainer Kotz, Winfried Winkelmann, Stefan S. Bielack

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

BACKGROUND. Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown. METHODS. Twenty-two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium-153-ethylene diamine tetramethylene phosphonate therapy. Follow-up ranged between 24 months and 105 months (median, 47 months). RESULTS. The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059). CONCLUSIONS. Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radio- therapy may be beneficial.

Original languageEnglish
Pages (from-to)1069-1077
Number of pages9
JournalCancer
Volume94
Issue number4
DOIs
Publication statusPublished - Feb 15 2002
Externally publishedYes

Fingerprint

Osteosarcoma
Spine
Neoplasms
Survival
Neoplasm Metastasis
Samarium
Sacrum
Organophosphonates

Keywords

  • Chemotherapy
  • Osteosarcoma
  • Radiotherapy
  • Sacrum
  • Spine
  • Surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ozaki, T., Flege, S., Liljenqvist, U., Hillmann, A., Delling, G., Salzer-Kuntschik, M., ... Bielack, S. S. (2002). Osteosarcoma of the spine: Experience of the Cooperative Osteosarcoma Study Group. Cancer, 94(4), 1069-1077. https://doi.org/10.1002/cncr.10258

Osteosarcoma of the spine : Experience of the Cooperative Osteosarcoma Study Group. / Ozaki, Toshihumi; Flege, Silke; Liljenqvist, Ulf; Hillmann, Axel; Delling, Günter; Salzer-Kuntschik, Mechthild; Jürgens, Heribert; Kotz, Rainer; Winkelmann, Winfried; Bielack, Stefan S.

In: Cancer, Vol. 94, No. 4, 15.02.2002, p. 1069-1077.

Research output: Contribution to journalArticle

Ozaki, T, Flege, S, Liljenqvist, U, Hillmann, A, Delling, G, Salzer-Kuntschik, M, Jürgens, H, Kotz, R, Winkelmann, W & Bielack, SS 2002, 'Osteosarcoma of the spine: Experience of the Cooperative Osteosarcoma Study Group', Cancer, vol. 94, no. 4, pp. 1069-1077. https://doi.org/10.1002/cncr.10258
Ozaki T, Flege S, Liljenqvist U, Hillmann A, Delling G, Salzer-Kuntschik M et al. Osteosarcoma of the spine: Experience of the Cooperative Osteosarcoma Study Group. Cancer. 2002 Feb 15;94(4):1069-1077. https://doi.org/10.1002/cncr.10258
Ozaki, Toshihumi ; Flege, Silke ; Liljenqvist, Ulf ; Hillmann, Axel ; Delling, Günter ; Salzer-Kuntschik, Mechthild ; Jürgens, Heribert ; Kotz, Rainer ; Winkelmann, Winfried ; Bielack, Stefan S. / Osteosarcoma of the spine : Experience of the Cooperative Osteosarcoma Study Group. In: Cancer. 2002 ; Vol. 94, No. 4. pp. 1069-1077.
@article{56c21e87de434abc88074f118997fed4,
title = "Osteosarcoma of the spine: Experience of the Cooperative Osteosarcoma Study Group",
abstract = "BACKGROUND. Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown. METHODS. Twenty-two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium-153-ethylene diamine tetramethylene phosphonate therapy. Follow-up ranged between 24 months and 105 months (median, 47 months). RESULTS. The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059). CONCLUSIONS. Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radio- therapy may be beneficial.",
keywords = "Chemotherapy, Osteosarcoma, Radiotherapy, Sacrum, Spine, Surgery",
author = "Toshihumi Ozaki and Silke Flege and Ulf Liljenqvist and Axel Hillmann and G{\"u}nter Delling and Mechthild Salzer-Kuntschik and Heribert J{\"u}rgens and Rainer Kotz and Winfried Winkelmann and Bielack, {Stefan S.}",
year = "2002",
month = "2",
day = "15",
doi = "10.1002/cncr.10258",
language = "English",
volume = "94",
pages = "1069--1077",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Osteosarcoma of the spine

T2 - Experience of the Cooperative Osteosarcoma Study Group

AU - Ozaki, Toshihumi

AU - Flege, Silke

AU - Liljenqvist, Ulf

AU - Hillmann, Axel

AU - Delling, Günter

AU - Salzer-Kuntschik, Mechthild

AU - Jürgens, Heribert

AU - Kotz, Rainer

AU - Winkelmann, Winfried

AU - Bielack, Stefan S.

PY - 2002/2/15

Y1 - 2002/2/15

N2 - BACKGROUND. Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown. METHODS. Twenty-two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium-153-ethylene diamine tetramethylene phosphonate therapy. Follow-up ranged between 24 months and 105 months (median, 47 months). RESULTS. The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059). CONCLUSIONS. Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radio- therapy may be beneficial.

AB - BACKGROUND. Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown. METHODS. Twenty-two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium-153-ethylene diamine tetramethylene phosphonate therapy. Follow-up ranged between 24 months and 105 months (median, 47 months). RESULTS. The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059). CONCLUSIONS. Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radio- therapy may be beneficial.

KW - Chemotherapy

KW - Osteosarcoma

KW - Radiotherapy

KW - Sacrum

KW - Spine

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=0037083643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037083643&partnerID=8YFLogxK

U2 - 10.1002/cncr.10258

DO - 10.1002/cncr.10258

M3 - Article

C2 - 11920477

AN - SCOPUS:0037083643

VL - 94

SP - 1069

EP - 1077

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -