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Survival and prognosis with osteosarcoma: outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort

S. Smeland, SS. Bielack, J. Whelan, M. Bernstein, P. Hogendoorn, MD. Krailo, R. Gorlick, KA. Janeway, FC. Ingleby, J. Anninga, I. Antal, C. Arndt, KLB. Brown, T. Butterfass-Bahloul, G. Calaminus, M. Capra, C. Dhooge, M. Eriksson, AM. Flanagan, G....

. 2019 ; 109 (-) : 36-50. [pub] 20190125

Jazyk angličtina Země Velká Británie

Typ dokumentu klinické zkoušky, fáze III, časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc20022856

Grantová podpora
MC_UU_12023/28 Medical Research Council - United Kingdom
P01 CA106450 NCI NIH HHS - United States
P30 CA008748 NCI NIH HHS - United States

BACKGROUND: High-grade osteosarcoma is a primary malignant bone tumour mainly affecting children and young adults. The European and American Osteosarcoma Study (EURAMOS)-1 is a collaboration of four study groups aiming to improve outcomes of this rare disease by facilitating randomised controlled trials. METHODS: Patients eligible for EURAMOS-1 were aged ≤40 years with M0 or M1 skeletal high-grade osteosarcoma in which case complete surgical resection at all sites was deemed to be possible. A three-drug combination with methotrexate, doxorubicin and cisplatin was defined as standard chemotherapy, and between April 2005 and June 2011, 2260 patients were registered. We report survival outcomes and prognostic factors in the full cohort of registered patients. RESULTS: For all registered patients at a median follow-up of 54 months (interquartile range: 38-73) from biopsy, 3-year and 5-year event-free survival were 59% (95% confidence interval [CI]: 57-61%) and 54% (95% CI: 52-56%), respectively. Multivariate analyses showed that the most adverse factors at diagnosis were pulmonary metastases (hazard ratio [HR] = 2.34, 95% CI: 1.95-2.81), non-pulmonary metastases (HR = 1.94, 95% CI: 1.38-2.73) or an axial skeleton tumour site (HR = 1.53, 95% CI: 1.10-2.13). The histological subtypes telangiectatic (HR = 0.52, 95% CI: 0.33-0.80) and unspecified conventional (HR = 0.67, 95% CI: 0.52-0.88) were associated with a favourable prognosis compared with chondroblastic subtype. The 3-year and 5-year overall survival from biopsy were 79% (95% CI: 77-81%) and 71% (95% CI: 68-73%), respectively. For patients with localised disease at presentation and in complete remission after surgery, having a poor histological response was associated with worse outcome after surgery (HR = 2.13, 95% CI: 1.76-2.58). In radically operated patients, there was no good evidence that axial tumour site was associated with worse outcome. CONCLUSIONS: In conclusion, data from >2000 patients registered to EURAMOS-1 demonstrated survival rates in concordance with institution- or group-level osteosarcoma trials. Further efforts are required to drive improvements for patients who can be identified to be at higher risk of adverse outcome. This trial reaffirms known prognostic factors, and owing to the large numbers of patients registered, it sheds light on some additional factors to consider.

Cancer Institute University College London London UK

CDC MRC Clinical Trials Unit at UCL London UK

COG Baylor College of Medicine Houston TX USA

COG Boston Children's Hospital Boston MA USA

COG Children's Oncology Group Arcadia CA USA

COG Cincinnati Children's Hospital Medical Center Cincinnati OH USA

COG Connecticut Children's Medical Center Hartford CT USA

COG Dana Farber Cancer Institute Boston MA USA

COG Five Prime Therapeutics Inc South San Francisco CA USA

COG IWK Health Center Dalhousie University Halifax NS Canada

COG Keck School of Medicine University of Southern California Los Angeles CA USA

COG Mayo Clinic Rochester MN USA

COG Memorial Sloan Kettering Cancer Center New York NY USA

COG Nationwide Children's Hospital and the Ohio State University Columbus OH USA

COG Primary Childrens Hospital The University of Utah Salt Lake City UT USA

COG Southwestern and Children's Medical Center Dallas TX USA

COG the University of Texas M D Anderson Cancer Center Houston TX USA

COG UCSF Medical Center Mission Bay Pediatric Oncology San Francisco CA USA

COG University of British Columbia Vancouver BC Canada

COG University of Washington Seattle WA USA

COSS Helios Kliniken Berlin Buch Berlin Germany

COSS Klinik Schillerhöhe Thoraxchirurgie Gerlingen Germany

COSS Klinikum Stuttgart Olgahospital Stuttgart Germany

COSS Medizinische Universität Wien Vienna Austria

COSS Semmelweis Egyetem Budapest Budapest Hungary

COSS St Anna Kinderspital CCRI Wien Austria

COSS Universitätsklinikum Essen Essen Germany

COSS Universitätsklinikum Ulm Ulm Germany

COSS Universitätsspital Basel Basel Switzerland

COSS University Hospital MOTOL Praha Czech Republic

EISD Centre for Clinical Trials University Hospital Muenster Muenster Germany

EOI Leiden University Medical Center Leiden the Netherlands

EOI Netherlands

EOI Our Lady's Children's Hospital Dublin Ireland

EOI Royal National Orthopaedic Hospital Stanmore

EOI Royal Orthopaedic Hospital Birmingham UK

EOI University College Hospital London UK

EOI University Hospital Ghent Gent Belgium

EOI University Hospital Leuven Leuven Belgium

QLCC Pädiatrische Hämatologie und Onkologie Universitätsklinikum Bonn Bonn Germany

SSG Lund University Lund Sweden

SSG Oslo University Hospital and Scandinavian Sarcoma Group and Institute for Clinical Medicine University of Oslo Norway

SSG Oslo University Hospital Oslo Norway

SSG Rigshospitalet University of Copenhagen Copenhagen Denmark

TMG Path Leiden University Medical Centre Leiden Netherlands

Citace poskytuje Crossref.org

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