To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: AAOS: Increased Rate of Secondary Cancers Seen in Long-Term Osteosarcoma Survivors URL: http://www.pslgroup.com/dg/22B4D2.htm Doctor's Guide February 6, 2003
By Jill Stein Special to DG News NEW ORLEANS, LA -- February 5, 2003 -- Overall incidence of secondary malignancies among long-term survivors of osteosarcoma is significantly increased compared to the expected rate of cancer in the general population. Based on study observations, however, researchers say that the successes of current treatment regimens for the primary tumour, consisting of intensive, high-dose chemotherapy in combination with topoisomerase II inhibitors, dramatically outweighs the risks. These new findings were released today at the Annual Meeting of the American Association of Orthopedic Surgeons (AAOS). Dr. John Healey and colleagues at Memorial Sloan-Kettering Cancer Center in New York, reviewed the incidence of second malignant neoplasms occurring in 509 long-term survivors of osteosarcoma treated at their institution during a recent seven-year period. All subjects had undergone chemotherapy and/or surgery on one of six different protocols. The improved survival in children with cancer has resulted in an extremely "ominous" long-term problem associated with therapy, namely the occurrence of secondary malignant neoplasms, Dr. Healey observed. A large body of information has been available regarding secondary cancers after treatment of Hodgkin's disease, retinoblastoma, and acute lymphoblastic leukaemia because a favorable cure rate has been achieved for several years, resulting in many long-term survivors. However, only limited information has been available on the second malignant neoplasms occurring in long-term survivors of osteosarcomas. In the present trial, chemotherapy had been scheduled for up to 40 weeks with some variations in the actual treatment period and involved various combinations of the following agents: high-dose methotrexate, doxorubicin, bleomycin, cyclophosphamide, dactinomycin, vincristine, cisplatin, and ifosfamide. Secondary malignant neoplasms occurred in 14 patients. Only one had pulmonary involvement at the time of diagnosis and underwent bilateral thoracotomies, and additional modification of the chemotherapy regimen. The median age at diagnosis for osteosarcoma was 16.6 years, and the median follow-up was 5.2 years. The time interval from diagnosis of the primary osteosarcoma to the development of secondary malignant neoplasm was 1.3 to 13.1 years. The most common secondary malignant neoplasm was in the central nervous system (n=4). These included anaplastic glioma, meningioma, high-grade glioma, and maxillary astrocytoma. There were two cases of acute myeloid leukemia and one case each of myelodysplastic syndrome, non-Hodgkin's lymphoma, high-grade pleomorphic sarcoma, leiomysosarcoma, fibrosarcoma, breast cancer, and mucoepidermoid carcinoma. The overall 5-year and 10-year cumulative incidence of second malignant neoplasms were 1.4% ± 1.1% and 3.1% ± 3.8%. The standardized incidence ratio was 4.6 ( p=0.00001) for the cohort and 3.64 (p=0.0007) when patients with a history of retinoblastoma or Rothmund-Thomson were excluded. Dr. Healey said that the standardized incidence ratio of secondary malignancies in long-term survivors of osteosarcoma is much less than those reported for Hodgkin's disease and retinoblastoma. This observation may be due to factors such as an earlier age at diagnosis and the higher cumulative dose and dose per course of alkylating agents received. While the overall incidence of secondary malignancies in long-term survivors of osteosarcoma was significantly higher than the expected incidence of cancer in the general population, the frequency is still low, Dr. Healey observed. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.