Outcome after relapse in childhood and adolescent osteosarcoma :
single institution experience in Korea

Lee, Yun-Jeong; Lee, Hyun-Jae; Kim, Dong-Ho; Lim, Jung-Sub; Lee, Jun-Ha; Park, Kyung-Duk; Jeon, Dae-Geun; Lee, Soo-Yong

Original Article

Korean Journal of Pediatrics 2008;51(1):78-83.
Published online January 15, 2008.

Outcome after relapse in childhood and adolescent osteosarcoma : single institution experience in Korea

Yun-Jeong Lee¹, Hyun-Jae Lee¹, Dong-Ho Kim¹, Jung-Sub Lim¹, Jun-Ha Lee¹, Kyung-Duk Park¹, Dae-Geun Jeon², Soo-Yong Lee²

¹Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
²Department of Orthopedics, Korean Cancer Center Hospital, Seoul, Korea

소아 청소년 골육종 재발 후 치료성적 : 한국의 단일기관 성적

이윤정^¹^, 이현재^¹^, 김동호^¹^, 임중섭^¹^, 이준아^¹^, 박경덕^¹^, 전대근^²^, 이수용^²

^¹원자력병원 소아청소과
^²원자력병원 정형외과

Correspondence:
Kyung-Duk Park, Email: kd4kid@Kcch.re.kr

Abstract

Purpose
: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Although survival rate of osteosarcoma patients has markedly improved, about 20-30% of patients still have a relapse. This study was aimed to find factors that influence postrelapse survival of osteosarcoma in childhood and adolescents.
Methods
: Between 1985 and 2004, of 461 patients who were diagnosed and treated as osteosarcoma in Korean Cancer Center Hospital, 180 patients with recurrent osteosarcoma were retrospectively reviewed. We examined survival rates and analyzed prognostic factors, such as relapse site, post-relapse treatment methods, pathologic response to neoadjuvnat chemotherapy, metastasis at first diagnosis, and relapse free interval.
Results
: The overall recurrence rate of patients with osteosarcoma was 39%. The 5-year and 10-year postrelapse survival rates in the recurrent osteosarcoma were 13% and 4%, respectively. The 5-year post-relapse survival rate was influenced by site of relapse (lung, 39%; local, 0%; lung & bone, 25%; others, 12%; P<0.05), relapse-free interval (<12 months, 13%; ≥12 months, 44%, P<0.05), and post- relapse treatment methods (with surgery, 38%; without surgery, 11%; P<0.05).
Conclusion
: The survival rate of recurrent case is very low after 10 years, so new second-line chemotherapy and active treatment is needed to increase survival. Aggressive surgery with the removal of recurrence sites combined with multi-agent chemotherapy could either cure patients with recurrent osteosarcoma or significantly prolong their survival.

Key Words: Osteosarcoma, Recurrence, Survival rate