A population-based analysis of the presentation and outcomes of pediatric patients with osteosarcoma in Canada: a report from CYP-C.

Can J Surg

Department of Surgery, Sections of General Surgery (Horkoff) and Orthopaedic Surgery (Kendal), University of Calgary, Calgary, Alta.; Department of Surgery, Division of Pediatric General Surgery (Blackmore), Dalhousie University, Halifax, NS; Arnie Charbonneau Cancer Research Institute (Truong, Guilcher), Department of Oncology, and Alberta Children's Hospital Research Institute (Truong, Guilcher, Brindle), Department of Pediatrics, Cumming School of Medicine (Truong, Guilcher), and Department of Surgery (Brindle), Section of Pediatric Surgery, University of Calgary, Calgary, Alta.

Published: August 2022

Background: Frequently occurring in adolescents, osteosarcoma is the most common primary malignant bone disease, with a reported 15% of patients who present with metastasis. With advances in imaging and improvements in surgical care, an updated analysis is warranted on the outcomes of pediatric patients with osteosarcoma.

Methods: We completed a retrospective review of pediatric patients who presented with osteosarcoma between 2001 and 2017, using The Cancer in Young People in Canada (CYP-C) national database. Data on 304 patients aged younger than 15 years were analyzed.

Results: The proportion of patients who presented with metastasis was 23.0%. The overall 5-year survival (OS) for patients who presented with metastasis was 37.4%. Overall survival and event-free survival (EFS) were lower in these patients than in patients with localized disease (hazard ratio [HR] 4.3, < 0.0001 and HR 3.1, < 0.0001). For patients who presented with metastatic disease, the OS for those undergoing an operative intervention was 44.1% compared with 17.6% for those who did not undergo resection ( < 0.0001).

Conclusion: The proportion of patients who presented with metastatic osteosarcoma in our population is higher than previously reported. Overall outcomes of patients with metastatic disease have not changed. Our data reaffirm a role for surgical resection in patients with metastasis with a need to explore new treatment strategies to improve the overall prognosis of these patients.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377546PMC
http://dx.doi.org/10.1503/cjs.008220DOI Listing

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