The Journal of the Korean bone and joint tumor society (대한골관절종양학회지)

The Korean Musculoskeletal Tumor Society (대한근골격종양학회)
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Distal Radius Osteosarcoma

원위 요골 골육종

  • Song, Won-Seok (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Won, Ho-Hyun (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Lee, Jeong-Dong (Department of Orthopedic Surgery, Korea Cancer Center Hospital) ;
  • Jeon, Dae-Geun (Department of Orthopedic Surgery, Korea Cancer Center Hospital)
  • Received : 2010.08.10
  • Accepted : 2010.10.20
  • Published : 2010.12.30
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Abstract

Purpose: We analyzed the clinical outcome of osteosarcoma developed in distal radius and the effect of delayed treatment on prognosis. Materials and Methods: Twelve patients with distal radius osteosarcoma were analysed. We categorized patients into two groups of standard treatment or non-standard treatment. The patients of standard treatment group are all stage IIB and non-standard treatment group includes five stage IIB and one stage III. Results: Five-year overall survival and disease-free survival rates of standard treatment group were 100% and 83%. Five-year overall survival rate of non-standard treatment group was 44%. Between two group, there are differences in age, tumor size, surgery type, symptom duration. Conclusion: Distal radius osteosarcoma have good prognosis than other extremity osteosarcoma. Survival rate of non-standard treatment group were lower than standard treatment group. Although the prognosis of non standard treatment group is poorer, the duration till death was longer than that of other sites with similar condition. Further multi-institutional study should be needed.

목적: 원위요골에 발생한 골육종의 치료 결과를 분석하고 치료의 지연으로 인한 결과의 차이를 알아보고자 하였다. 대상 및 방법: 12예의 원위요골 골육종 환자를 대상으로 하였으며 진단 및 치료 지연 유무에 따라 두 군으로 나누어 임상 및 병리학적인 인자를 분석하였다. 표준 치료군 6예는 전부 Enneking stage IIB였으며 비표준 치료군 6예는 stage IIB가 5예 III가 1예였다. 결과: 표준 치료군의 5년 실질 및 무병 생존율은 100%, 83%였다. 비표준 치료군의 5년 실질 생존율은 44%였다. 표준치료군과 비표준 치료군은 환자의 평균나이(12세 vs 41세, 종양의 크기(24 ml vs 447 ml), 수술방법(사지구제술 6예 vs 절단술 5예), 치료 전 증상기간(1개월 vs 40개월)이 차이가 있었다. 결론: 표준적인 치료를 받은 원위요골 골육종은 타 부위의 골육종의 평균 생존율에 비해 높았다. 진단 및 치료지연이 있었던 환자는 낮은 생존율을 보였으나 동일한 조건의 타 부위에 비해서는 사망에 이르는 기간이 길었다. 이 부위의 골육종이 사지 3대 호발보위와 병태생리가 다를 가능성이 있으나 더 연구가 필요하다.

Keywords

References

  1. Bacci G, Forni C, Longhi A, et al. Local recurrence and local control of non-metastatic osteosarcoma of the extremities: a 27-year experience in a single institution. J Surg Oncol. 2007;96:118-23. https://doi.org/10.1002/jso.20628
  2. Damron TA, Ward WG, Stewart A. Osteosarcoma, chondrosarcoma, and Ewing's sarcoma: National Cancer Data Base Report. Clin Orthop Relat Res. 2007;459:40-7. https://doi.org/10.1097/BLO.0b013e318059b8c9
  3. Le Deley MC, Guinebretiere JM, Gentet JC, et al. Societe Francaise d'Oncologie Pediatrique (SFOP). SFOP OS94: a randomised trial comparing preoperative high-dose methotrexate plus doxorubicin to high-dose methotrexate plus etoposide and ifosfamide in osteosarcoma patients. Eur J Cancer. 2007;43:752-61. https://doi.org/10.1016/j.ejca.2006.10.023
  4. Lewis IJ, Nooij MA, Whelan J, et al. MRC BO06 and EORTC 80931 collaborators; European Osteosarcoma Intergroup. Improvement in histologic response but not survival in osteosarcoma patients treated with intensified chemotherapy: a randomized phase III trial of the European Osteosarcoma Intergroup. J Natl Cancer Inst. 2007;99:112-28. https://doi.org/10.1093/jnci/djk015
  5. Petrilli AS, de Camargo B, Filho VO, et al Brazilian Osteosarcoma Treatment Group studies III and IV. Results of the Brazilian Osteosarcoma Treatment Group studies III and IV: prognostic factors and impact on survival. J Clin Oncol. 2006;24:1161-8. https://doi.org/10.1200/JCO.2005.03.5352
  6. Bacci G, Longhi A, Versari M, et al. Prognostic factors for osteosarcoma of the extremity treated with neoadjuvant chemotherapy: 15-year experience in 789 patients treated at a single institution. Cancer. 2006;106:1154-61. https://doi.org/10.1002/cncr.21724
  7. Bielack SS, Kempf-Bielack B, Delling G, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol. 2002;20:776-90. https://doi.org/10.1200/JCO.20.3.776
  8. Bieling P, Rehan N, Winkler P, et al. Tumor size and prognosis in aggressively treated osteosarcoma. J Clin Oncol. 1996;14:848-58. https://doi.org/10.1200/JCO.1996.14.3.848
  9. Carsi B, Rock MG. Primary osteosarcoma in adults older than 40 years. Clin Orthop Relat Res. 2002;391:53-61.
  10. Kim MS, Lee SY, Lee TR, et al. Prognostic nomogram for predicting the 5-year probability of developing metastasis after neoadjuvant chemotherapy and definitive surgery for AJCC stage II extremity osteosarcoma. Ann Oncol. 2009;20:955-60. https://doi.org/10.1093/annonc/mdn723
  11. Kim MS, Lee SY, Cho WH, et al. An examination of the efficacy of the 8 cm maximal tumor diameter cutoff for the subdivision of AJCC stage II osteosarcoma patients. J Surg Oncol. 2008;98:427-31. https://doi.org/10.1002/jso.21125
  12. Kim MS, Lee SY, Cho WH, et al. Initial tumor size predicts histologic response and survival in localized osteosarcoma patients. J Surg Oncol. 2008;97:456-61. https://doi.org/10.1002/jso.20986
  13. Lee JA, Kim MS, Kim DH, et al. Risk stratification based on the clinical factors at diagnosis is closely related to the survival of localized osteosarcoma. Pediatr Blood Cancer. 2009; 52:340-5. https://doi.org/10.1002/pbc.21843
  14. Pakos EE, Nearchoua AD, Grimer RJ, et al. Prognostic factors and outcomes for osteosarcoma: an international collaboration. Eur J Cancer. 2009;2367-75. https://doi.org/10.1016/j.ejca.2009.03.005
  15. Bramer JA, van Linge JH, Grimer RJ, Scholten RJ. Prognostic factors in localized extremity osteosarcoma: a systematic review. Eur J Surg Oncol. 2009;35:1030-6. https://doi.org/10.1016/j.ejso.2009.01.011
  16. Cho WH, Song WK, Jeon DG, et al. Differential presentations, clinical courses, and survivals of osteosarcomas of the proximal humerus over other extremity locations. Ann Surg Oncol. 2010;17:702-8. https://doi.org/10.1245/s10434-009-0825-6
  17. Daecke W, Bielack S, Martini AK, et al. Osteosarcoma of the hand and forearm: experience of the cooperative osteosarcoma study group. Ann Surg Oncol. 2005;12:322-31. https://doi.org/10.1245/ASO.2005.06.002
  18. Gobel V, Jurgens H, Etspuler G, et al. Prognostic significance of tumor volume in localized Ewing's sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol. 1987;113:187-91. https://doi.org/10.1007/BF00391442
  19. Kim MS, Lee SY, Cho WH, et al. Tumor necrosis rate adjusted by tumor volume change is a better predictor of survival of localized osteosarcoma patients. Ann Surg Oncol. 2008;15:906-14. https://doi.org/10.1245/s10434-007-9779-8
  20. Kim MS, Cho WH, Song WS, Lee SY, Jeon DG. Time dependency of prognostic factors in patients with stage II osteosarcomas. Clin Orthop Relat Res. 2007;463:157-65.
  21. Rosen G, Marcove RC, Huvos AG, et al. Primary osteogenic sarcoma: eight-year experience with adjuvant chemotherapy. J Cancer Res Clin Oncol. 1983;106(Suppl):55-67. https://doi.org/10.1007/BF00625054
  22. Bentzen SM, Poulsen HS, Kaae S, et al. Prognostic factors in osteosarcomas. A regression analysis. Cancer. 1988;62:194-202. https://doi.org/10.1002/1097-0142(19880701)62:1<194::AID-CNCR2820620129>3.0.CO;2-8
  23. Goorin AM, Perez-Atayde A, Gebhardt M, et al. Weekly highdose methotrexate and doxorubicin for osteosarcoma: The Dana-Farber Cancer Institute/the Children's Hospital-study III. J Clin Oncol. 1987;5:1178-84. https://doi.org/10.1200/JCO.1987.5.8.1178
  24. Provisor AJ, Ettinger LJ, Nachman JB, et al. Treatment of nonmetastatic osteosarcoma of the extremities with preoperative and postoperative chemotherapy: a report of the Children's Cancer Group. J Clin Oncol. 1997;15:79-84.