Prognostic factors in pediatric osteosarcoma presenting with pulmonary metastasis: experience of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Le résumé fourni par la source

Introduction. Approximately 20% of newly diagnosed pediatric patients with high-grade osteosarcoma present with metastatic disease, with the lungs being the predominant site of dissemination. In the absence of universally accepted criteria for defining pulmonary metastases and assessing the resectability of metastatic lesions, treatment strategies for metastatic osteosarcoma remain highly individualized and depend on the experience of the treating institution. Objective – to evaluate clinicopathological characteristics and outcomes of osteosarcoma patients presenting with pulmonary metastases, and to identify prognostic factors associated with survival. Materials and methods. The study included newly diagnosed pediatric patients with histologically confirmed high-grade osteosarcoma and isolated pulmonary metastases, prospectively registered at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology between January 1, 2012, and December 31, 2023. All patients received specific therapy according to the MAP regimen (based on the EURAMOS-1 protocol). Treatment outcomes were evaluated by event-free survival (EFS) and overall survival (OS) rates, calculated using the Kaplan–Meier method. Results. Among 354 patients with high-grade osteosarcoma, isolated pulmonary metastases were identified in 96 patients (27.1%). The 5-year OS and EFS rates for the entire cohort were 46.8% and 31.1%, respectively. The median follow-up duration was 5.83 years. In patients who received combined therapy including multi-agent chemotherapy and surgical resection of both primary and metastatic lesions, the 5-year OS and EFS reached 70% and 47%, respectively. Key favorable prognostic factors included having no more than 10 metastatic lung lesions and a good histologic response to preoperative chemotherapy at the primary tumor site. Conclusion. The treatment outcomes of patients diagnosed with osteosarcoma and isolated pulmonary metastases in the Russian Federation are comparable to international data. The effectiveness of therapy in this patient group directly depends on the coordinated work of a multidisciplinary team, including pediatric oncologists, orthopedic surgeons, thoracic surgeons, radiologists, and pathologists.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.