COMPARISON OF PRIMARY OSTEOSARCOMA OF FLAT BONES WITH SECONDARY OSTEOSARCOMA OF ANY SITE

BACKGROUND. The authors hypothesized that the outcomes for young patie nts who present with primary osteosarcoma of flat bones or secondary o steosarcoma after other primary malignancies are similar because the s ites of these tumors rarely makes them amenable to complete surgical r esection. METHODS, The authors reviewed their experience with 27 patie nts with primary osteosarcomas involving flat bones and 18 patients wi th secondary osteosarcomas of any site, evaluating treatment, metastat ic patterns, and outcome. RESULTS, Eleven of the 27 primary osteosarco mas and 10 of the 18 secondary osteosarcomas were at least partially r esectable at the time of initial diagnosis. At last follow-up, 10 of t he 27 patients with primary flat bone osteosarcoma were alive, eight o f whom were disease free. Three of 18 with the secondary osteosarcoma patients were alive, including one with locally recurrent disease afte r recent disease resections. Chemotherapy with single or combinations of agents rarely yielded responses for primary flat bone or secondary osteosarcomas. CONCLUSIONS, Outcome for both groups of patients was po or due to metastases and failure of local control. Sixteen of the 27 p atients with primary osteosarcoma of flat bones died of their tumor; a n additional patient died of doxorubicin-related cardiomyopathy and ha d microscopic disease in the primary site at autopsy. Thirteen of the 18 patients with secondary osteosarcoma died of their second metastati c cancer, 2 additional patients died of doxorubicin-related cardiomyop athy/coccidioidomycosis, and another of acute renal toxicity. (C) 1997 American Cancer Society.