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  • 1
    Article
    Article
    2007
    ISSN: 1750-1172 
    Language: English
    In: Orphanet journal of rare diseases, 2007-01-23, Vol.2 (1), p.6-6
    Description: Osteosarcoma is a primary malignant tumour of the skeleton characterised by the direct formation of immature bone or osteoid tissue by the tumour cells. The classic osteosarcoma is a rare (0.2% of all malignant tumours) highly malignant tumour, with an estimated incidence of 3 cases/million population/year. Osteosarcoma arises predominantly in the long bones and rarely in the soft tissues. The age at presentation ranges from 10 to 25 years of age. Plain radiographs, computed tomography, magnetic resonance imaging, angiography and dynamic bone scintigraphy are used for diagnosis, evaluation the extent of tumour involvement and decision of the type of operation and, if necessary, the type of reconstruction. Years ago, all patients with osteosarcoma were treated by amputation but the cure rate was under 10% and almost all patients died within a year from diagnosis. Today, for localised osteosarcoma at onset (80% of cases) treated in specialized bone tumour centres with pre- and postoperative chemotherapy associated with surgery, the percentage of patients cured varies between 60% and 70%. Surgery is conservative (limb salvage) in more than 90% of patients. Prognosis is more severe (cure rate about 30%) for tumours located in the axial skeleton and in patients with metastasis at onset.
    Subject(s): Diagnosis, Differential ; Age Distribution ; Bone Neoplasms - diagnosis ; Prognosis ; Bone Neoplasms - therapy ; Neoplasms, Bone Tissue - diagnosis ; Humans ; Middle Aged ; Bone Neoplasms - epidemiology ; Male ; Lung Neoplasms - therapy ; Osteosarcoma - diagnosis ; Incidence ; Osteosarcoma - epidemiology ; Lung Neoplasms - secondary ; Adolescent ; Sex Distribution ; Adult ; Female ; Neoplasm Staging ; Child ; Osteosarcoma - therapy ; Review
    ISSN: 1750-1172
    E-ISSN: 1750-1172
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 2
    Language: English
    In: The lancet oncology, 2015, Vol.16 (1), p.98-107
    Description: Summary Background Results of previous study showed promising but short-lived activity of sorafenib in the treatment of patients with unresectable advanced and metastatic osteosarcoma. This treatment failure has been attributed to the mTOR pathway and might therefore be overcome with the addition of mTOR inhibitors. We aimed to investigate the activity of sorafenib in combination with everolimus in patients with inoperable high-grade osteosarcoma progressing after standard treatment. Methods We did this non-randomised phase 2 trial in three Italian Sarcoma Group centres. We enrolled adults (≥18 years) with relapsed or unresectable osteosarcoma progressing after standard treatment (methotrexate, cisplatin, and doxorubicin, with or without ifosfamide). Patients received 800 mg sorafenib plus 5 mg everolimus once a day until disease progression or unacceptable toxic effects. The primary endpoint was 6 month progression-free survival (PFS). All analyses were intention-to-treat. This trial is registered with ClinicalTrials.gov , number NCT01804374. Findings We enrolled 38 patients between June 16, 2011, and June 4, 2013. 17 (45%; 95% CI 28–61) of 38 patients were progression free at 6 months. Toxic effects led to dose reductions, or short interruptions, or both in 25 (66%) of 38 patients and permanent discontinuation for two (5%) patients. The most common grade 3–4 adverse events were lymphopenia and hypophosphataemia each in six (16%) patients, hand and foot syndrome in five (13%), thrombocytopenia in four (11%), and fatigue, oral mucositis, diarrhoea, and anaemia each in two (5%). One patient (3%) had a grade 3 pneumothorax that required trans-thoracic drainage, and that recurred at the time of disease progression. This was reported as a serious adverse event related to the study drugs in both instances. No other serious adverse events were reported during the trial. There were no treatment-related deaths. Interpretation Although the combination of sorafenib and everolimus showed activity as a further-line treatment for patients with advanced or unresectable osteosarcoma, it did not attain the prespecified target of 6 month PFS of 50% or greater. Funding Italian Sarcoma Group.
    Subject(s): Hematology, Oncology and Palliative Medicine ; Niacinamide - analogs & derivatives ; Osteosarcoma - drug therapy ; TOR Serine-Threonine Kinases - metabolism ; Humans ; Middle Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Male ; Bone Neoplasms - pathology ; TOR Serine-Threonine Kinases - antagonists & inhibitors ; Young Adult ; Neoplasm Grading ; Time Factors ; Adult ; Female ; Bone Neoplasms - drug therapy ; Everolimus ; Sirolimus - analogs & derivatives ; Bone Neoplasms - enzymology ; Osteosarcoma - enzymology ; Kaplan-Meier Estimate ; Treatment Outcome ; Disease Progression ; Niacinamide - administration & dosage ; Disease-Free Survival ; Sirolimus - administration & dosage ; Phenylurea Compounds - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Adolescent ; Intention to Treat Analysis ; Italy ; Osteosarcoma - secondary ; Antimitotic agents ; Chemotherapy ; Osteosarcoma ; Stem cells ; Clinical trials ; Product development ; Antineoplastic agents ; Standards ; Cancer
    ISSN: 1470-2045
    E-ISSN: 1474-5488
    Source: Alma/SFX Local Collection
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  • 3
    Language: English
    In: Journal of surgical oncology, 2012-12-15, Vol.106 (8), p.929-937
    Description: Introduction Aim of this study was to analyze (1) survival, local recurrence (LR), and metastasis rates between the three histological tumor grades; (2) whether type of treatment and tumor site influenced prognosis for each histologic grade. Methods We retrospectively studied 296 patients with central conventional chondrosarcomas (CS) (87 grade 1, 162 grade 2, and 47 grade 3). The femur was the most common site (91 cases), followed by the pelvis (82) and other less frequent sites. Type of surgery was related with histologic grade. Margins were wide in 222 cases, marginal in 23, and intralesional in 51 cases. Results At a mean of 7 years, 201 patients remained continuously NED, 33 were NED after treatment of relapse, 15 were AWD, 35 were died of disease, and 12 of other causes. Survival was 92% at 5 years and 84% at 10 years, significantly influenced by histological grading. In grade 3 CS, two factors influenced survival: type of surgery (resection vs. amputation, P = 0.051) and site (P = 0.039). The two significant factors lost their significance at multivariate analysis. Conclusion Central conventional CS with low/intermediate grade has a good prognosis, while high‐grade tumors have poor outcome. Tumor relapses are strictly related with histologic grade. J. Surg. Oncol. 2012; 106: 929–937. © 2012 Wiley Periodicals, Inc.
    Subject(s): chondrosarcoma ; surgical treatment ; prognostic factors ; clinical outcome ; grade ; Chondrosarcoma - surgery ; Prognosis ; Femoral Neoplasms - pathology ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Male ; Treatment Outcome ; Bone Neoplasms - surgery ; Pelvis ; Bone Neoplasms - pathology ; Young Adult ; Neoplasm Metastasis ; Neoplasm Grading ; Adolescent ; Survival Analysis ; Aged, 80 and over ; Chondrosarcoma - pathology ; Adult ; Female ; Aged ; Retrospective Studies ; Femoral Neoplasms - surgery ; Patient outcomes ; Metastasis
    ISSN: 0022-4790
    E-ISSN: 1096-9098
    Source: Alma/SFX Local Collection
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  • 4
    Language: English
    In: Technology in Cancer Research & Treatment, 2019-07-19, Vol.18, p.1533033819840000-1533033819840000
    Description: Background: Primary and recurrent giant cell tumor of bone is typically benign; however, rarely giant cell tumor of bone can undergo malignant transformation. Malignancy in giant cell tumor of bone may be primary (adjacent to benign giant cell tumor of bone at first diagnosis) or secondary (at the site of previously treated giant cell tumor of bone). Malignant giant cell tumor of bone has a poor prognosis; it is important to distinguish malignant from benign lesions to facilitate appropriate management. The true incidence of malignant giant cell tumor of bone is not known, probably owing to inaccurate diagnosis and inconsistent nomenclature. We have analyzed current data to provide a robust estimate of the incidence of malignancy in giant cell tumor of bone. Methods: A literature search was performed to source published reports of primary and secondary cases of malignant giant cell tumor of bone. Studies that reported a denominator were used to estimate the incidence of malignancy. Results: We identified 4 large series of patients with malignant giant cell tumor of bone that provided data on 2315 patients with giant cell tumor of bone. Across these studies, the cumulative incidence of malignancy was 4.0%; the cumulative incidence of primary malignancy was 1.6% compared with 2.4% for secondary malignancy. Our analyses confirmed that most malignant giant cell tumor of bone is secondary and occurs following radiation. In addition, data from 8 small series showed that 4.8% of patients with giant cell tumor of bone who received radiation therapy developed secondary malignancy. Conclusions: Malignant giant cell tumor of bone is rare, and its identification is hindered by a lack of clear diagnostic criteria. For optimal care of patients with giant cell tumor of bone, we recommend: comprehensive histologic sampling to ensure accurate diagnoses; watchful follow-up, particularly for patients treated with radiation; and timely treatment of local recurrence.
    Subject(s): Life Sciences & Biomedicine ; Oncology ; Science & Technology ; bone tumors ; rare disease ; diagnosis ; Review ; incidence ; prognosis ; clinical features
    ISSN: 1533-0346
    E-ISSN: 1533-0338
    Source: Web of Science - Science Citation Index Expanded - 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
    Source: ProQuest Central
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  • 5
    Language: English
    In: BMC genomics, 2009-12-23, Vol.10 (1), p.625-625
    Description: Pulmonary metastasis continues to be the most common cause of death in osteosarcoma. Indeed, the 5-year survival for newly diagnosed osteosarcoma patients has not significantly changed in over 20 years. Further understanding of the mechanisms of metastasis and resistance for this aggressive pediatric cancer is necessary. Pet dogs naturally develop osteosarcoma providing a novel opportunity to model metastasis development and progression. Given the accelerated biology of canine osteosarcoma, we hypothesized that a direct comparison of canine and pediatric osteosarcoma expression profiles may help identify novel metastasis-associated tumor targets that have been missed through the study of the human cancer alone. Using parallel oligonucleotide array platforms, shared orthologues between species were identified and normalized. The osteosarcoma expression signatures could not distinguish the canine and human diseases by hierarchical clustering. Cross-species target mining identified two genes, interleukin-8 (IL-8) and solute carrier family 1 (glial high affinity glutamate transporter), member 3 (SLC1A3), which were uniformly expressed in dog but not in all pediatric osteosarcoma patient samples. Expression of these genes in an independent population of pediatric osteosarcoma patients was associated with poor outcome (p = 0.020 and p = 0.026, respectively). Validation of IL-8 and SLC1A3 protein expression in pediatric osteosarcoma tissues further supported the potential value of these novel targets. Ongoing evaluation will validate the biological significance of these targets and their associated pathways. Collectively, these data support the strong similarities between human and canine osteosarcoma and underline the opportunities provided by a comparative oncology approach as a means to improve our understanding of cancer biology and therapies.
    Subject(s): Interleukin-8 - genetics ; Oligonucleotide Array Sequence Analysis ; Genomics ; Humans ; Gene Expression Profiling ; Comparative Genomic Hybridization - methods ; Excitatory Amino Acid Transporter 1 - genetics ; Animals ; Dogs ; Cell Line, Tumor ; RNA, Neoplasm - genetics ; Osteosarcoma - genetics ; Child ; Cluster Analysis ; Development and progression ; Usage ; Genetic aspects ; DNA microarrays ; Research ; Osteosarcoma ; Research article
    ISSN: 1471-2164
    E-ISSN: 1471-2164
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 6
    Language: English
    In: BMC cancer, 2010-08-29, Vol.10 (1), p.462-462
    Description: Giant cell tumour of bone (GCTB) is an expansile osteolytic tumour which contains numerous osteoclast-like giant cells. GCTB frequently recurs and can produce metastatic lesions in the lungs. Bisphosphonates are anti-resorptive drugs which act mainly on osteoclasts. In this study, we have examined clinical and radiological outcomes of treatment with aminobisphosphonates on 25 cases of aggressive primary, recurrent and metastatic GCTB derived from four European centres. We also analysed in vitro the inhibitory effect of zoledronic acid on osteoclasts isolated from GCTBs. Treatment protocols differed with several different aminobisphosphonates being employed, but stabilisation of disease was achieved in most of these cases which were refractory to conventional treatment. Most inoperable sacral/pelvic tumours did not increase in size and no further recurrence was seen in GCTBs that had repeatedly recurred in bone and soft tissues. Lung metastases did not increase in size or number following treatment. Zoledronic acid markedly inhibited lacunar resorption by GCTB-derived osteoclasts in vitro. Our findings suggest that bisphosphonates may be useful in controlling disease progression in GCTB and that these agents directly inhibit GCTB - derived osteoclast resorption. These studies highlight the need for the establishment of standardised protocols to assess the efficacy of bisphosphonate treatment of GCTB.
    Subject(s): Lung Neoplasms - drug therapy ; Humans ; Middle Aged ; Bone Neoplasms - secondary ; Neoplasm Recurrence, Local - drug therapy ; Male ; Antineoplastic Agents - therapeutic use ; Neoplasm Recurrence, Local - pathology ; Young Adult ; Giant Cell Tumor of Bone - drug therapy ; Giant Cell Tumor of Bone - pathology ; Lung Neoplasms - secondary ; Diphosphonates - therapeutic use ; Adult ; Female ; Bone Neoplasms - drug therapy ; Imidazoles - therapeutic use ; Tumor Cells, Cultured ; Bone Resorption ; Osteoclasts - pathology ; Neoplasm Invasiveness ; Treatment Outcome ; Adolescent ; Aged ; Osteoclasts - drug effects ; Development and progression ; Bone tumors ; Dosage and administration ; Research ; Drug therapy ; Diphosphonates
    ISSN: 1471-2407
    E-ISSN: 1471-2407
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 7
    Language: English
    In: Journal of clinical oncology, 2012-06-10, Vol.30 (17), p.2112-2118
    Description: We compared two chemotherapy regimens that included methotrexate (MTX), cisplatin (CDP), and doxorubicin (ADM) with or without ifosfamide (IFO) in patients with nonmetastatic osteosarcoma of the extremity. Patients age ≤ 40 years randomly received regimens with the same cumulative doses of drugs (ADM 420 mg/m(2), MTX 120 g/m(2), CDP 600 mg/m(2), and IFO 30 g/m(2)) but with different durations (arm A, 44 weeks; arm B, 34 weeks). IFO was given postoperatively when pathologic response to MTX-CDP-ADM was poor (arm A) or given in the primary phase of chemotherapy with MTX-CDP-ADM (arm B). End points of the study included pathologic response to preoperative chemotherapy, toxicity, and survival. Given the feasibility of accrual, the statistical plan only permitted detection of a 15% difference in 5-year overall survival (OS). From April 2001 to December 2006, 246 patients were enrolled. Two hundred thirty patients (94%) underwent limb salvage surgery (arm A, 92%; arm B, 96%; P = .5). Chemotherapy-induced necrosis was good in 45% of patients (48% in arm A, 42% in arm B; P = .3). Four patients died of treatment-related toxicity (arm A, n = 1; arm B, n = 3). A significantly higher incidence of hematologic toxicity was reported in arm B. With a median follow-up of 66 months (range, 1 to 104 months), 5-year OS and event-free survival (EFS) rates were not significantly different between arm A and arm B, with OS being 73% (95% CI, 65% to 81%) in arm A and 74% (95% CI, 66% to 82%) in arm B and EFS being 64% (95% CI, 56% to 73%) in arm A and 55% (95% CI, 46% to 64%) in arm B. IFO added to MTX, CDP, and ADM from the preoperative phase does not improve the good responder rate and increases hematologic toxicity. IFO should only be considered in patients who have a poor histologic response to MTX, CDP, and ADM.
    Subject(s): Biological and medical sciences ; Medical sciences ; Diseases of the osteoarticular system ; Tumors of striated muscle and skeleton ; Tumors ; Osteosarcoma - drug therapy ; Femur - pathology ; Humans ; Child, Preschool ; Male ; Tibia - pathology ; Cisplatin - administration & dosage ; Humerus - pathology ; Disease-Free Survival ; Ifosfamide - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemotherapy, Adjuvant - methods ; Adolescent ; Adult ; Female ; Methotrexate - administration & dosage ; Bone Neoplasms - drug therapy ; Child ; Doxorubicin - administration & dosage
    ISSN: 0732-183X
    E-ISSN: 1527-7755
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 8
    Language: English
    In: Virchows Archiv : an international journal of pathology, 2018-05, Vol.472 (5), p.815-824
    Description: Ewing’s sarcoma family of tumors (ESFT) are aggressive neoplasms with scant tumor-infiltrating lymphocytes. We analyzed the immunohistochemical (IHC) expression of PD-L1 and PD-1 and their prognostic significance in clinically localized neoplasms in a cohort of 370 ESFT. Slides prepared from tissue microarrays were stained for PD-L1, PD-1, and CD8. Membranous/cytoplasmic staining over 5% of tumor cells was regarded as positive for PD-L1 and PD-1. Prognostic analysis was done considering only clinically localized tumors (n = 217). PD-L1 expression was present in 19% of ESFT, while PD-1 was expressed in 26%. Forty-eight percent of tumors were negative and 12% were positive for both PD-L1 and PD-1. Metastatic tumors displayed higher expression of PD-L1 (p 〈 0.0001). Histological subtypes were not correlated with PD-L1 or PD-1 positivity. ESFT with elevated proliferation index (Ki-67) were associated with higher PD-L1 expression (p = 0.049). Regarding prognosis, no significant association was found between PD-L1 expression and progression-free survival (PFS) or overall survival (OS), whereas lack of PD-1 expression in tumor cells was correlated with both poor PFS (p = 0.02) and poor OS (p = 0.004). Tumor-infiltrating CD8(+) T lymphocytes were observed in 15.4% of ESFT with informative results (347 tumors). No correlation was found between tumor-infiltrating CD8(+) T lymphocytes and ESFT histological subtypes, tumor location, or PD-1 and PD-L1 expression, nor with PFS (p = 0.473) or OS (p = 0.087). PD-L1 expression was not significantly related to prognosis. PD-1 was expressed in 26% of ESFT tumor cells and may have prognostic and therapeutic implications. CD8 expression in tumor-infiltrating lymphocytes was not related to prognosis.
    Subject(s): Immunohistochemistry ; Pathology ; Ewing sarcoma ; Medicine & Public Health ; PD-L1 ; Prognostic factor ; PD-1 ; Bone Neoplasms - mortality ; CD8-Positive T-Lymphocytes - pathology ; Prognosis ; Humans ; Middle Aged ; Sarcoma, Ewing - pathology ; Child, Preschool ; Infant ; Male ; Sarcoma, Ewing - mortality ; Bone Neoplasms - pathology ; Young Adult ; Programmed Cell Death 1 Receptor - biosynthesis ; Aged, 80 and over ; Adult ; Female ; Child ; Biomarkers, Tumor - analysis ; Kaplan-Meier Estimate ; Bone Neoplasms - immunology ; Sarcoma, Ewing - immunology ; Disease-Free Survival ; Lymphocytes, Tumor-Infiltrating - pathology ; B7-H1 Antigen - biosynthesis ; Adolescent ; Aged ; Biomarkers, Tumor - immunology ; Metastasis ; Sarcoma ; T cells
    ISSN: 0945-6317
    E-ISSN: 1432-2307
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Molecular cancer, 2009-12-10, Vol.8 (1), p.118-118
    Description: Osteosarcoma (OS) is the most common primary bone tumour in children and young adults. Despite improved prognosis, metastatic or relapsed OS remains largely incurable and no significant improvement has been observed in the last 20 years. Therefore, the search for alternative agents in OS is mandatory. We investigated phospho-ERK 1/2, MCL-1, and phospho-Ezrin/Radixin/Moesin (P-ERM) as potential therapeutic targets in OS. Activation of these pathways was shown by immunohistochemistry in about 70% of cases and in all OS cell lines analyzed. Mutational analysis revealed no activating mutations in KRAS whereas BRAF gene was found to be mutated in 4/30 OS samples from patients. Based on these results we tested the multi-kinase inhibitor sorafenib (BAY 43-9006) in preclinical models of OS. Sorafenib inhibited OS cell line proliferation, induced apoptosis and downregulated P-ERK1/2, MCL-1, and P-ERM in a dose-dependent manner. The dephosphorylation of ERM was not due to ERK inhibition. The downregulation of MCL-1 led to an increase in apoptosis in OS cell lines. In chick embryo chorioallantoic membranes, OS supernatants induced angiogenesis, which was blocked by sorafenib and it was also shown that sorafenib reduced VEGF and MMP2 production. In addition, sorafenib treatment dramatically reduced tumour volume of OS xenografts and lung metastasis in SCID mice. In conclusion, ERK1/2, MCL-1 and ERM pathways are shown to be active in OS. Sorafenib is able to inhibit their signal transduction, both in vitro and in vivo, displaying anti-tumoural activity, anti-angiogenic effects, and reducing metastatic colony formation in lungs. These data support the testing of sorafenib as a potential therapeutic option in metastatic or relapsed OS patients unresponsive to standard treatments.
    Subject(s): Niacinamide - analogs & derivatives ; Osteosarcoma - drug therapy ; Vascular Endothelial Growth Factor A - biosynthesis ; Cytoskeletal Proteins - antagonists & inhibitors ; Apoptosis - drug effects ; Humans ; Extracellular Signal-Regulated MAP Kinases - antagonists & inhibitors ; Male ; Antineoplastic Agents - therapeutic use ; Benzenesulfonates - therapeutic use ; Phenylurea Compounds ; Extracellular Signal-Regulated MAP Kinases - metabolism ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Proto-Oncogene Proteins c-bcl-2 - metabolism ; Benzenesulfonates - pharmacology ; Neoplasm Metastasis - prevention & control ; Osteosarcoma - blood supply ; Cytoskeletal Proteins - metabolism ; Female ; Neovascularization, Pathologic - prevention & control ; Antineoplastic Agents - pharmacology ; Matrix Metalloproteinase 2 - biosynthesis ; Osteosarcoma - metabolism ; Pyridines - therapeutic use ; Down-Regulation - drug effects ; Cell Division - drug effects ; Animals ; Myeloid Cell Leukemia Sequence 1 Protein ; Cell Line, Tumor ; Matrix Metalloproteinase Inhibitors ; Proto-Oncogene Proteins c-bcl-2 - antagonists & inhibitors ; Mice ; Pyridines - pharmacology ; Osteosarcoma - pathology ; Development and progression ; Diagnosis ; Drug therapy ; Osteosarcoma ; Risk factors ; Research
    ISSN: 1476-4598
    E-ISSN: 1476-4598
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 10
    Language: English
    In: Journal of clinical oncology, 2013-06-20, Vol.31 (18), p.2303-2312
    Description: The LIVESTRONG Young Adult Alliance has conducted a meta-analysis of individual patient data from prospective neoadjuvant chemotherapy osteosarcoma studies and registries to examine the relationships of sex, age, and toxicity on survival. Suitable data sets were identified by a survey of published data reported in PubMed. The final pooled data set comprised 4,838 patients from five international cooperative groups. After accounting for important variables known at study entry such as tumor location and histology, females experienced higher overall survival rates than males (P = .005) and children fared better than adolescents and adults (P = .002). Multivariate landmark analysis following surgery indicated that a higher rate of chemotherapy-induced tumor necrosis was associated with longer survival (P 〈 .001), as was female sex (P = .004) and the incidence of grade 3 or 4 mucositis (P = .03). Age group was not statistically significant in this landmark analysis (P = .12). Females reported higher rates of grade 3 or 4 thrombocytopenia relative to males (P 〈 .001). Children reported the highest rates of grade 3 or 4 neutropenia (P 〈 .001) and thrombocytopenia (P 〈 .001). The achievement of good tumor necrosis was higher for females than for males (P = .002) and for children than for adults (P 〈 .001). These results suggest fundamental differences in the way chemotherapy is handled by females compared with males and by children compared with older populations. These differences may influence survival in a disease in which chemotherapy is critical to overall outcomes.
    Subject(s): Biological and medical sciences ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Medical sciences ; Diseases of the osteoarticular system ; Tumors of striated muscle and skeleton ; Tumors ; Osteosarcoma - drug therapy ; Multivariate Analysis ; Prospective Studies ; Age Factors ; Humans ; Kaplan-Meier Estimate ; Combined Modality Therapy ; Thrombocytopenia - chemically induced ; Bone Neoplasms - surgery ; Young Adult ; Regression Analysis ; Outcome Assessment (Health Care) - statistics & numerical data ; Osteosarcoma - surgery ; Chemotherapy, Adjuvant - adverse effects ; Neoadjuvant Therapy - adverse effects ; Adolescent ; Sex Factors ; Adult ; Bone Neoplasms - drug therapy ; Neutropenia - chemically induced ; Child ; Clinical Medicine ; Medical and Health Sciences ; Klinisk medicin ; Cancer and Oncology ; Medicin och hälsovetenskap ; Cancer och onkologi
    ISSN: 0732-183X
    ISSN: 1527-7755
    E-ISSN: 1527-7755
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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