Pediatric osteosarcoma: Therapeutic strategies, results, and prognostic factors derived from a 10-year experience

Melissa Hudson, Mark Robert Jaffe, Norman Jaffe, Alberto Ayala, A. Kevin Raymond, Humberto Carrasco, Sidney Wallace, John Murray, Resa Robertson

Research output: Contribution to journalArticlepeer-review

174 Scopus citations


Ninety-eight pediatric patients were treated with three separate protocols (Treatment and Investigation of Osteosarcoma [TIOS] I, II, and III) and 47 developed recurrent disease (metastases and/or local recurrence). Actuarial overall disease-free survival (hereafter designated survival) was 43%. Over 90% of the patients were treated initially with preoperative intraarterial cisplatin (CDP). Postoperative chemotherapeutic regimens comprised high-dose methotrexate with leucovorin rescue (MTX-CF), Adriamycin ([ADR] doxorubicin; Adria Laboratories, Columbus, OH), and cyclophosphamide. Primary definitive treatment comprised amputation or limb salvage (TIOS I and TIOS III). Patients treated with preoperative CDP and sur-gery (TIOS I and III) had a 62% survival. Patients in TIOS II refused surgical extirpation; they were treated exclusively with chemotherapy and had a 23% survival. Survival in patients treated with amputation was 55% and limb salvage 58%. Prognostic factors considered significant in relation to development of pulmonary metastases comprised tumor burden (P = .04) and the percentage of tumor necrosis induced by preoperative chemotherapy (P = .01). Histopathologic subtype was marginally significant: chondroblastic was more favorable as opposed to osteoblastic (P = .05). These findings are compared with results and prognostic factors published in the literature.

Original languageEnglish (US)
Pages (from-to)1988-1997
Number of pages10
JournalJournal of Clinical Oncology
Issue number12
StatePublished - Dec 1990

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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