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Multiple relapses in high-grade osteosarcoma: when to stop aggressive therapy?

Gevorg Tamamyan1, Martin Dominkus, Susanna Lang

  • 1Department of Pediatrics, St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria.

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Aggressive surgery is crucial for long-term survival in children with recurrent high-grade osteosarcoma. Even with multiple relapses, complete surgical remission offers a positive prognosis.

Keywords:
osteosarcomapediatric oncologytumors bone

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Area of Science:

  • Pediatric Oncology
  • Surgical Oncology
  • Cancer Immunology

Background:

  • High-grade osteosarcoma relapse carries a poor prognosis.
  • Complete tumor resection is vital for patient survival.
  • The COSS-96 protocol is a standard treatment for osteosarcoma.

Observation:

  • A 6-year-old patient with high-grade osteosarcoma experienced five relapses within five years.
  • Each relapse was successfully treated with complete surgical remission.
  • The patient also received chemotherapy and dendritic cell-based immunotherapy.

Findings:

  • The patient has survived for 11.5 years since the end of therapy for the fifth relapse.
  • Aggressive surgical intervention was key to achieving complete remission in all instances.
  • This case demonstrates the potential for long-term survival despite multiple osteosarcoma recurrences.

Implications:

  • Aggressive surgical management should be considered for recurrent high-grade osteosarcoma.
  • Multidisciplinary treatment approaches, including immunotherapy, may improve outcomes.
  • Further research into surgical strategies for relapsed osteosarcoma is warranted.