Progression before local control in osteosarcoma: Outcome and prognosis-predictive factors

Area of Science:

• Pediatric Oncology
• Skeletal System Neoplasms
• Cancer Progression

Background:

• Prognosis and impact of early osteosarcoma progression before local control (LC) are underexplored.
• Potential therapeutic benefits of ifosfamide/etoposide (IE) in this context require further investigation.

Purpose of the Study:

• To investigate the prognosis of pediatric osteosarcoma patients with early disease progression before local control.
• To evaluate the impact of ifosfamide/etoposide (IE) treatment on outcomes for patients with early osteosarcoma progression.

Main Methods:

• Retrospective study of pediatric osteosarcoma patients (≤18 years) diagnosed between June 2006 and March 2022.
• Analysis focused on patients experiencing disease progression prior to local control (LC).

Main Results:

• 31 out of 195 patients showed progression before LC; 25 had local-site-only progression, 6 had combined local/metastatic progression.
• Patients with local-site-only progression had better outcomes compared to those with combined progression.
• Five patients received IE intensification, all of whom progressed; 5-year event-free survival was 27.2%, overall survival was 31.3%.

Conclusions:

• Early osteosarcoma progression before LC is linked to a poor prognosis.
• Localized disease progression may have a better outcome, suggesting potential for targeted interventions.
• Further research with larger cohorts is needed to clarify the role of IE in managing early osteosarcoma progression.