December 2, 2005

Survival Rate Still Poor When Bone Cancer Returns

NEW YORK (Reuters Health) - Although as many as 70 percent of patients who have the localized stage of the bone cancer osteosarcoma survive after surgery and chemotherapy, the overall survival rate after recurrence is less than 30 percent, researchers report.

However, lead investigator Dr. Paul A. Meyers told Reuters Health, "the chances of survival are better for patients whose recurrence is detected after a longer interval from the completion of initial therapy and for patients whose recurrence is limited to fewer sites."

Meyers of Memorial Sloan-Kettering Cancer Center and colleagues examined data on patients who achieved complete remission and those who were treated for a first recurrence at that institution after 1990.

Of 43 eligible patients, the average time from diagnosis to recurrence was 22 months, the team reports in medical journal Cancer. Recurrence was in the lungs in 33 of the patients. At an average follow-up of 15 months, only 15 (35 percent) of the patients were still alive.

None of the 8 patients who underwent only chemotherapy survived, while 3 of the 4 who underwent only surgery survived. Of the 31 treated with surgery and chemotherapy, 22 achieved a second complete remission. Of these patients, 9 (29 percent) were alive and in remission at the time of the last follow-up.

A cure is never achieved without complete surgical removal of the recurrent cancer at all detectable sites, Meyers noted.

"The probability for long-term disease-free survival," he added, "may be enhanced by the use of high-dose ifosfamide" after surgery. However, he and his colleagues conclude, "In the end, the role of chemotherapy in recurrent osteosarcoma continues to remain undefined."

SOURCE: Cancer, November 15, 2005.