Abstract
BackgroundFew reports have described clinical features, prognosis and prognostic factors of osteosarcoma patients according to age.MethodsUsing the Bone and Soft Tissue Tumor Registry in Japan, we identified 1043 osteosarcoma patients including 760 who were younger than 40 years, 173 aged between 41 and 64 years, and 110 patients older than 65 years. We extracted data on patient demographics and prognosis. Prognostic factors for patients older than 65 years or other age groups were analyzed.ResultsPatients older than 65 years showed a significantly higher proportion of tumors arising in the trunk and with metastasis at diagnosis, and their 5-year disease-specific survival (DSS) rate was 32.7%. Multivariate analysis showed that the presence of metastasis at diagnosis [hazard ratio (HR): 3.04; 95% confidence interval (CI), 1.63–5.69; P < 0.001] and tumors > 16 cm in size (HR: 2.84 compared with < 8 cm; 95% CI, 1.16–6.97; P = 0.023) were significantly associated with worse DSS. The 5-year DSS was 39.1% in 80 patients older than 65 years without metastasis at diagnosis. Methotrexate was used in only 5.0% of these patients. Adjuvant chemotherapy was not significantly associated with better DSS (P = 0.323) in this generation and aged between 41 and 64 years (P = 0.566), although adjuvant chemotherapy yielded significantly better survival in patients younger than 40 years (P < 0.001).ConclusionsAnalysis of this cohort of osteosarcoma patients revealed some unique clinical, therapeutic and prognostic features according to age groups in the largest cohort. Adjuvant chemotherapy was not associated with a better DSS in the group of patients aged between 41 and 64 years or older than 65 years.
Highlights
Few reports have described clinical features, prognosis and prognostic factors of osteosarcoma patients according to age
We aimed to clarify the clinical features, outcomes and prognostic factors of osteosarcoma patients according to age groups using the Bone and Soft Tissue Tumor (BSTT) Registry, a nationwide organ-specific cancer registry of bone and soft tissue tumors in Japan
Patients characteristics and treatments During 2006–2013, we identified the records of 1043 patients with high grade osteosarcoma treated at 96 hospitals in the BSTT Registry
Summary
Few reports have described clinical features, prognosis and prognostic factors of osteosarcoma patients according to age. Osteosarcoma is often secondary to Paget’s disease or previous radiotherapy [1, 2]. Approximately half of osteosarcomas in patients older than 60 years are primary tumors [3]. Paget’s disease are uncommon in Japan [4,5,6], elderly osteosarcoma patients are relatively rare, and the age distribution of osteosarcoma has shown a single peak in the second decade [7, 8]. The number of elderly patients with primary osteosarcoma has been increasing [7]. The age distribution of osteosarcoma in Japan is bimodal, with a peak in the seventh decade as well as in the second decade [7].
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