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Late relapse of osteosarcoma: Implications for follow‐up and screening
Author(s) -
Strauss Sandra J.,
McTiernan Anne,
Whelan Jeremy S.
Publication year - 2004
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20154
Subject(s) - medicine , osteosarcoma , surgery , disease , chemotherapy , pathology
Long‐term disease‐free survival in patients with localised osteosarcoma treated in large multicentre randomised trials is over 50%. Most relapses occur early, usually within 2–3 years. Relapse after 5 years is uncommon and has been infrequently described. Eight patients with osteosarcoma treated at The London Bone and Soft Tissue Tumour Service since 1986 developed recurrence of disease after 5 years, the latest 14 years after the initial diagnosis. Five patients developed pulmonary metastases, two patients isolated bone metastases and one patient intra‐abdominal metastases. Although a second complete remission was achieved in six patients, four patients relapsed again, all with pulmonary metastases. Two patients had co‐existent brain metastases. One of those with a second recurrence has achieved a further complete remission and remains well 50 months after the most recent treatment. A second patient is disease‐free 24 months after complete excision of an isolated pulmonary metastasis and one further patient is disease‐free 6 months after chemotherapy and pneumonectomy for pleural and pulmonary metastases. Five patients have died of disease with a median survival from the date of relapse of 17 months (2–68 months). Current data looking at long‐term outcome of patients with osteosarcoma is limited. Reports of late relapse are rare as numbers are small, thus long‐term surveillance of patients is essential. It is possible that sites of relapse are more unusual, and more extensive staging may be necessary when late relapse occurs. © 2004 Wiley‐Liss, Inc.