Abstract
Introduction
Osteosarcoma is typically a disease of the young, but may affect any age. Little is
known about the disease in older patients beyond retirement age. We aim to describe
the characteristics, treatment, and outcomes of older adult patients registered with
our cooperative group.
Materials and Methods
The database of the Cooperative Osteosarcoma Study Group (COSS) was searched for osteosarcoma
patients diagnosed from 1980 to 2020 who were aged 65 years or older at diagnosis.
Affected individuals were analyzed for presenting factors, treatments employed, and
outcomes.
Results
Fifty-five eligible patients were detected (median age 68 [range: 65–84] years; male:female = 25:30).
Among these patients, 15/55 (27%) tumors were secondary malignancies, 41/55 (75%)
were high-grade central, 4/55 (7%) surface, and 10/55 (18%) extraosseous malignancies,
and all but three high-grade. Primary metastases were present in 15/55 (27%) patients.
Surgery was reported for 46/55 (84%) patients, radiotherapy for 6/54 (11%, 1 unknown),
chemotherapy for 42/50 (84%, 5 unknown). A complete surgical remission was achieved
in 31/55 (56%). There were two toxic deaths. With a median follow-up of 1.7 (range:
0.1–18.0) years for all 55 patients and 2.2 (0.1–12.4) years for 24 survivors, event-free
and overall survival at 2/5 years were 39.6% (standard error: 6.8%) / 24.5% (6.5%)
and 62.0% (7.1%) / 32.7% (7.5%), respectively. Tumor site, metastatic status, surgery,
and a complete surgical remission were prognostic for event-free and/or overall survival.
Discussion
Osteosarcomas can occur in older individuals. It is more often secondary, axially
located, or extraosseous than in younger patients. However, the same treatment principles
seem to apply, and selected patients may be cured. Multi-center cooperation is encouraged,
thereby gathering expertise for such a rare disease presentation.
Keywords
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Article info
Publication history
Published online: February 24, 2023
Accepted:
January 30,
2023
Received in revised form:
November 16,
2022
Received:
September 27,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
