The Effect of Adjuvant Chemotherapy on Localized Extraskeletal Osteosarcoma: A Systematic Review
by
, , , , and
Shinji Tsukamoto
1
,
Andreas F. Mavrogenis
2,*
,
Lucia Angelelli
3,
Alberto Righi
4,
Giuseppe Filardo
3,
Akira Kido
5,
Kanya Honoki
1
,
Yuu Tanaka
6,
Yasuhito Tanaka
1
and
Costantino Errani
7
1
Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan
2
First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens 15562, Greece
3
Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
4
Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy
5
Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-Cho, Kashihara 634-8521, Japan
6
Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, 3-1, Minamoto-Cho, Wakayama 640-8222, Japan
7
Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
*
Author to whom correspondence should be addressed.
Cancers 2022, 14(10), 2559; https://doi.org/10.3390/cancers14102559
Submission received: 23 April 2022
/
Revised: 20 May 2022
/
Accepted: 20 May 2022
/
Published: 23 May 2022
(This article belongs to the Section Clinical Research in Cancer)
Simple Summary
The effect of (neo) adjuvant chemotherapy on localized extraskeletal osteosarcomas (ESOS) is controversial. We conducted a systematic review of studies comparing 5-year disease-free survival between patients who underwent surgery combined with (neo) adjuvant chemotherapy and those who underwent surgery alone for localized ESOS. The 5-year disease-free survival rate in the surgery and (neo)adjuvant chemotherapy group was 47.9% (187 of 390 patients) and the 5-year disease-free survival rate in the surgery-only group was 40.4% (150 of 371 patients). The overall pooled odds ratio was 1.23 (95% confidence interval, 0.69 to 2.19; p = 0.479). The effect of adjuvant chemotherapy on localized ESOS may be limited. Therefore, routine adjuvant chemotherapy for localized ESOS should be avoided.
Abstract
(1) Background: Extraskeletal osteosarcoma (ESOS) is a malignant tumor characterized by the production of bone or bone matrix by tumor cells without any continuity into the skeletal bones. The standard treatment for localized ESOS is wide resection; however, the effect of (neo)adjuvant chemotherapy remains unclear. To investigate the effect of (neo)adjuvant chemotherapy for localized ESOS, we conducted a systematic review of studies comparing the 5-year disease-free survival rate between patients who underwent surgery combined with (neo)adjuvant chemotherapy and those who underwent surgery alone. (2) Methods: Of the 210 studies identified by systematically searching the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases, 12 were included in the final analysis. These 12 articles were not randomized controlled trials, but retrospective studies. In total, 761 patients with localized ESOS were included in this study. (3) Results: The 5-year disease-free survival rate was 47.9% (187 of 390 patients) in the surgery and (neo)adjuvant chemotherapy group and 40.4% (150 of 371 patients) in the surgery alone group. The overall pooled odds ratio was 1.23 (95% confidence interval, 0.69–2.19; p = 0.479) and the heterogeneity I2 was 37%. (4) Conclusions: The effect of adjuvant chemotherapy on localized ESOS seems to be limited. Therefore, routine use of adjuvant chemotherapy for localized ESOS should be avoided. However, further randomized controlled trials are required to confirm these results.
Keywords:
chemotherapy; extraskeletal osteosarcoma; prognosis; surgery; survival
