Key result
Adjuvant chemotherapy added to surgery showed no significant difference in outcome compared to surgery alone for patients with non-metastatic 'other' primary bone sarcomas (P=0.71).
Why the study?
No standard treatments had been developed for primary bone sarcomas other than osteosarcoma, Ewing sarcoma, and chondrosarcoma.
Does surgery plus chemotherapy improve survival in patients with non-metastatic primary bone sarcomas other than osteosarcoma, Ewing sarcoma and chondrosarcoma compared to surgery alone?
Observational (n=330)
Yes
Does surgery plus chemotherapy improve survival in patients with non-metastatic primary bone sarcomas other than osteosarcoma, Ewing sarcoma and chondrosarcoma compared to surgery alone?
p-value: p=0.71
In patients with rare primary bone sarcomas, definitive surgery provides a relatively good prognosis for non-metastatic disease, but the benefit of adjuvant chemotherapy remains unclear.
Adjuvant chemotherapy should not yet change practice after surgery; leaves open benefit in rare non-metastatic bone sarcomas.
BACKGROUND: To date, no standard treatments for primary bone sarcomas other than those for osteosarcoma, Ewing sarcoma and chondrosarcoma have been developed. METHODS: The clinical characteristics and prognostic factors of 330 patients with primary bone sarcomas other than osteosarcoma, Ewing sarcoma and chondrosarcoma, listed in a nationwide tumour registry (Bone and Soft Tissue Tumor Registry in Japan) were investigated. The effects of adjuvant chemotherapy were determined by comparing the outcomes of patients with non-metastatic bone tumours who received surgery plus chemotherapy with those of patients who underwent surgery alone. RESULTS: The most common diagnosis was undifferentiated high-grade pleomorphic sarcoma. Axial site tumours (47.8%) and distant metastases at presentation (24.5%) were frequent. The 5-year overall and progression-free survival rates were 44.9 and 39.9%, respectively. Prognostic factor analysis identified surgery as an independent predictor of overall survival, and distant metastases at presentation was significant and independent predictor of both overall and progression-free survival. No significant difference in outcome was observed between patients treated with surgery alone and those treated with surgery plus chemotherapy (P = 0.71). CONCLUSIONS: Patients with bone sarcomas other than osteosarcoma, Ewing sarcoma and chondrosarcoma without metastasis at presentation have a relatively good prognosis with definitive surgery; however, the benefit of adjuvant chemotherapy is unclear.
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Nagano et al. (2021) conducted an observational in Primary bone sarcomas other than osteosarcoma, Ewing sarcoma and chondrosarcoma (n=330). Surgery plus chemotherapy vs. Surgery alone was evaluated on Outcome (overall survival) (p=0.71). Adjuvant chemotherapy added to surgery showed no significant difference in outcome compared to surgery alone for patients with non-metastatic 'other' primary bone sarcomas (P=0.71).
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