Before the introduction of chemotherapy in the 1980’s, survival for patients with high-grade osteosarcoma was poor with survival probabilities as low as less than 20%. It continues to be a high risk malignancy and has one of the highest mortality rates of any type of cancer diagnosed around puberty. Despite being a rare disease (prevalence of 3–4 cases per million per year ), osteosarcoma is the most common primary malignant bone tumor.

The first peak is at the age of puberty and adolescence, the second curve arises after the age of 40. High-grade conventional osteosarcoma is a primary malignant bone tumor that has a bimodal distribution curve. Differences in outcome among different age groups can be partially explained by patient and treatment characteristics. Age groups, tumor size, poor histopathological response, distant metastasis (DM) at presentation and local recurrence (LR) were important independent prognostic factors influencing OS and EFS. In this study poor overall survival (OS) and event-free survival (EFS) were associated with increasing age. Prognostic factors for survival were analyzed using a Cox proportional hazard model. In this single center retrospective cohort study, 402 patients with skeletal high-grade osteosarcoma were diagnosed and treated with curative intent between 19 at the Leiden University Medical Center (LUMC). This study aims to provide an overview of survival in patients with high-grade osteosarcoma in different age groups and prognostic variables for survival and local control among the entire cohort. Abstract Age is a known prognostic factor for many sarcoma subtypes, however in the literature there are limited data on the different risk profiles of different age groups for osteosarcoma survival. Differences in outcome among different age groups can be partially explained by patient characteristics and treatment characteristics. Age groups, tumor size, poor histopathological response, distant metastasis at presentation, and local recurrence were independent prognostic factors associated to overall survival and event-free survival. In this study, in which 402 patients with skeletal high-grade osteosarcoma were included, poor survival was associated with increasing age. It shows prognostic variables for survival and local control among the overall cohort. This retrospective study provides an overview of survival in patients with high-grade osteosarcoma in different age groups. Simple Summary Age is one of many prognostic factors for overall survival in patients with skeletal osteosarcoma.

Subree subramanian