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Establishment of Cancer Stem Cell Cultures from Human Conventional Osteosarcoma
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Osteosarcoma: the COSS experience.

Stefan Bielack1, Herbert Jürgens, Gernot Jundt

  • 1Pädiatrie 5 (Onkologie, Hämatologie,Immunologie), Klinikum Stuttgart, Zentrum für Kinder- und Jugendmedizin-Olgahospital, Bismarckstr. 8, D-70176, Stuttgart, Germany. coss@olgahospital-stuttgart.de

Cancer Treatment and Research
|March 10, 2010
PubMed
Summary
This summary is machine-generated.

The Cooperative German-Austrian-Swiss Osteosarcoma Study Group (COSS) reviewed outcomes for 2,464 osteosarcoma patients treated with neoadjuvant chemotherapy. Limb-sparing surgery increased, and survival improved, particularly for localized extremity tumors.

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Area of Science:

  • Oncology
  • Orthopedic Surgery
  • Pediatric Oncology

Background:

  • The Cooperative German-Austrian-Swiss Osteosarcoma Study Group (COSS) has been a significant collaborative effort since 1977, registering over 3,500 bone sarcoma patients.
  • Osteosarcoma remains a challenging diagnosis, particularly in pediatric and adolescent populations, necessitating advancements in treatment protocols.

Purpose of the Study:

  • To review the outcomes of high-grade central osteosarcoma patients treated under neoadjuvant COSS protocols between 1980 and 2005.
  • To evaluate the impact of chemotherapy and surgical approaches on survival and treatment trends.
  • To assess prognostic factors, including tumor response to neoadjuvant chemotherapy.

Main Methods:

  • Retrospective analysis of 2,464 consecutive high-grade central osteosarcoma patients diagnosed between 1980 and 2005.
  • Patients were treated with neoadjuvant multidrug chemotherapy (methotrexate, doxorubicin, cisplatin, ifosfamide) followed by surgery.
  • Survival estimates were calculated based on tumor location and presence of metastases, with a median follow-up of 7.31 years for survivors.

Main Results:

  • Five- and 10-year survival rates were 0.748/0.695 for localized extremity tumors and 0.369/0.317 for axial tumors or primary metastases.
  • Tumor response to preoperative chemotherapy was identified as an independent prognostic factor.
  • A significant shift from amputation to limb-salvage surgery was observed, though less pronounced in younger children (<10 years).
  • Survival expectancies improved during the study period, with gains noted between the first and second halves of recruitment.

Conclusions:

  • Neoadjuvant chemotherapy and surgical advancements have improved outcomes for osteosarcoma patients treated by COSS.
  • Tumor response to chemotherapy is a critical predictor of survival.
  • Limb-salvage surgery is increasingly feasible, but age remains a factor in treatment approach.
  • Continued research and protocol refinement are essential for further improving osteosarcoma survival rates.