This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jaffe, N. Search for Related Content PubMed PubMed Citation Articles by Jaffe, N. Related Articles Related Article Related Reply Social Bookmarking                            What's this?

Metachronous Skeletal Osteosarcoma After Therapy

Division of Pediatrics, The University of Texas M.D. Anderson Cancer Center, Houston, TX

To the Editor:

The article by Aung et al¹ in the January 15, 2003 issue of the Journal of Clinical Oncology requires comment to permit accurate scientific perspective. In contrast to the statement "we are not aware of any published reports from the large, single institutions, reporting outcome for these patients (metachronous skeletal osteosarcoma) when treated with a combined modality treatment approach," the experience of post-therapy multiple metachronous primary osteosarcoma tumors in the pediatric population was presented in a general poster session at the annual meeting of the American Society of Clinical Oncology in May 2001.² The abstract presented data on 11 pediatric patients, following a review of 250 patients under 18 years of age, who presented to the M.D. Anderson Cancer Center (Houston, TX) with primary osteosarcoma of the skeleton without pulmonary metastases over the past 25 years. The interval between appearance of the primary and metachronous tumor varied from 12 to 78 months. Inter alia, the abstract addressed the concordance and discordance of the histologic varieties of the primary and metachronous tumors and referred to a possible increased incidence of the condition in patients with retinoblastoma.

The abstract also contradicts the statement "There is little information available on the experience and outcomes of metachronous metastatic skeletal overall survival." At the time of the report, with the use of cisplatin, adriamycin, high-dose methotrexate, cyclophosphamide, and ifosfamide with surgical resection of the metachronous tumors, five of the 11 patients were alive, 20+ to 50+ months and disease-free (four are currently still active and disease-free; the patient with a second rib metachronous tumor later succumbed to pulmonary metastases). These facts were not addressed in the Aung et al article.¹ Finally, we also emphasized that diligent follow-up of survivors of osteosarcoma is required to permit early detection and appropriate successful intervention.

Addendum: The abstract discussed above was recently published as an article in Cancer, where more details are available.³

Author's Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCES

1. Aung L, Gorlick R, Healey JH, et al: Metachronous skeletal osteosarcoma in patients treated with adjuvant and near adjuvant chemotherapy for non-metastatic osteosarcoma. J Clin Oncol 21:342-348, 2003[Abstract/Free Full Text]

2. Jaffe N, Pearson P, Yasko AK, et al: Post-therapy multiple metachronous primary osteosarcoma tumors. Proc Am Soc Clin Oncol 20:377, 2001 (abstr 1505)

3. Jaffe N, Pearson P, Yasko A, et al: Single and multiple metachronous osteosarcoma tumors after therapy. Cancer 98:2457-2466, 2003[CrossRef][Medline]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

Related Article

• Metachronous Skeletal Osteosarcoma in Patients Treated with Adjuvant and Neoadjuvant Chemotherapy for Nonmetastatic Osteosarcoma
  LeLe Aung, Richard Gorlick, John H. Healey, Weiji Shi, Howard T. Thaler, Nicholas A. Shorter, Andrew G. Huvos, and Paul A. Meyers
  JCO 2003 21: 342-348 [Abstract] [Full Text]

Related Reply

• In Reply:
  The ASCO Aromatase Inhibitors Technology Assessment Working Group
  JCO 2004 22: 1526-1527 [Full Text]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jaffe, N. Search for Related Content PubMed PubMed Citation Articles by Jaffe, N. Related Articles Related Article Related Reply Social Bookmarking                            What's this?