Abstract
Osteosarcoma developing in elderly persons has several characteristic features. A predilection for the axial skeleton, particularly the pelvis, has been noted. Secondary osteosarcoma due to preexisting conditions such as irradiated bone, Paget’s disease, fibrous dysplasia, and bone infarct is occasionally observed in the elderly. Because osteosarcoma is relatively rare in the aged persons, diagnostic delay is common, with this exerting a possibly adverse effect on prognosis. Treatment-related factors also may affect the prognosis of elderly patients with osteosarcoma. Difficulty in achieving wide resection is reported because axial bones are affected in a high proportion of elderly osteosarcoma patients. Tolerability and completion rate of chemotherapy are lower in the elderly as compared with younger patients. In this chapter, tumor-related features and treatment-related characteristics are described in elderly patients with osteosarcoma.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Dorfman HD, Czerniak B. Osteosarcoma. In: Dorfman HD, Czemiak B, editors. Bone tumors. St. Louis: Mosby; 1998. p. 128–252.
Bielack SS, et al. Combined modality treatment for osteosarcoma occurring as a second malignant disease. Cooperative German-Austrian-Swiss Osteosarcoma Study Group. J Clin Oncol. 1999;17(4):1164.
Dahlin DC, Coventry MB. Osteogenic sarcoma. A study of six hundred cases. J Bone Joint Surg Am. 1967;49(1):101–10.
Duffaud F, et al. Osteosarcomas of flat bones in adolescents and adults. Cancer. 2000;88(2):324–32.
Huvos AG. Osteogenic sarcoma of bones and soft tissues in older persons. A clinicopathologic analysis of 117 patients older than 60 years. Cancer. 1986;57(7):1442–9.
Huvos AG, et al. Postradiation osteogenic sarcoma of bone and soft tissues. A clinicopathologic study of 66 patients. Cancer. 1985;55(6):1244–55.
Shaylor PJ, et al. Paget’s osteosarcoma – no cure in sight. Sarcoma. 1999;3(3–4):191–2.
Mankin HJ, Hornicek FJ. Paget’s sarcoma: a historical and outcome review. Clin Orthop Relat Res. 2005;438:97–102.
Naka T, et al. Osteosarcoma versus malignant fibrous histiocytoma of bone in patients older than 40 years. A clinicopathologic and immunohistochemical analysis with special reference to malignant fibrous histiocytoma-like osteosarcoma. Cancer. 1995;76(6):972–84.
Mindell ER, Shah NK, Webster JH. Postradiation sarcoma of bone and soft tissues. Orthop Clin North Am. 1977;8(4):821–34.
Grimer RJ, et al. Osteosarcoma over the age of forty. Eur J Cancer. 2003;39(2):157–63.
Lewis VO, et al. Outcome of postradiation osteosarcoma does not correlate with chemotherapy response. Clin Orthop Relat Res. 2006;450:60–6.
Okada K, et al. Second primary osteosarcoma with rosette-like structure in a patient with retinoblastoma. Virchows Arch. 2004;445(4):421–4.
Nishida Y, et al. Osteosarcoma in the elderly over 60 years: a multicenter study by the Japanese Musculoskeletal Oncology Group. J Surg Oncol. 2009;100(1):48–54.
de Santos LA, et al. Osteogenic sarcoma after the age of 50: a radiographic evaluation. AJR Am J Roentgenol. 1978;131(3):481–4.
Longhi A, et al. Osteosarcoma in patients older than 65 years. J Clin Oncol. 2008;26(33):5368–73.
Bacci G, et al. Delay in diagnosis of high-grade osteosarcoma of the extremities. Has it any effect on the stage of disease? Tumori. 2000;86(3):204–6.
Campanacci M. Bone tumors. Philadelphia: Lippincott-Verlag; 1999. p. 1418–68.
Carsi B, Rock MG. Primary osteosarcoma in adults older than 40 years. Clin Orthop Relat Res. 2002;397:53–61.
Iwata S, et al. Prognostic factors in elderly osteosarcoma patients: a multi-institutional retrospective study of 86 cases. Ann Surg Oncol. 2014;21(1):263–8.
Manoso MW, et al. De novo osteogenic sarcoma in patients older than forty: benefit of multimodality therapy. Clin Orthop Relat Res. 2005;438:110–5.
Bielack SS, et al. Prognostic factors in high-grade osteosarcoma of the extremities or trunk: an analysis of 1,702 patients treated on neoadjuvant cooperative osteosarcoma study group protocols. J Clin Oncol. 2002;20(3):776–90.
Ferrari S, et al. Neoadjuvant chemotherapy with high-dose Ifosfamide, high-dose methotrexate, cisplatin, and doxorubicin for patients with localized osteosarcoma of the extremity: a joint study by the Italian and Scandinavian Sarcoma Groups. J Clin Oncol. 2005;23(34):8845–52.
Meyers PA, et al. Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience. J Clin Oncol. 1992;10(1):5–15.
Rosen G, et al. Preoperative chemotherapy for osteogenic sarcoma: selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy. Cancer. 1982;49(6):1221–30.
Bacci G, et al. Neoadjuvant chemotherapy for osteosarcoma of the extremities in patients aged 41–60 years: outcome in 34 cases treated with adriamycin, cisplatinum and ifosfamide between 1984 and 1999. Acta Orthop. 2007;78(3):377–84.
Song WS, et al. Prognosis of extremity osteosarcoma in patients aged 40–60 years: a cohort/case controlled study at a single institute. Eur J Surg Oncol. 2010;36(5):483–8.
Imai R, et al. Cervical spine osteosarcoma treated with carbon-ion radiotherapy. Lancet Oncol. 2006;7(12):1034–5.
Kamada T, et al. Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas. J Clin Oncol. 2002;20(22):4466–71.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer Japan
About this chapter
Cite this chapter
Nishida, Y. (2016). Osteosarcoma in the Elderly: Clinical Features and Outcome. In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_5
Download citation
DOI: https://doi.org/10.1007/978-4-431-55696-1_5
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-55695-4
Online ISBN: 978-4-431-55696-1
eBook Packages: MedicineMedicine (R0)