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Osteogenic Sarcoma



Recurrent Disease


Most recurrences of osteosarcoma develop within 2 to 3 years after treatment completion. Late recurrences are rare (<4%).


Recurrent disease in lung :-

  • Recurrence of osteosarcoma is most often in the lung.
  • Patients with recurrent osteosarcoma should be assessed for surgical resectability, as they may sometimes be cured with aggressive surgical resection with or without chemotherapy.
  • The ability to achieve a complete resection of recurrent disease is the most important prognostic factor at first relapse
    • 5-year survival rate of 20% to 45% following complete resection of metastatic pulmonary tumors.
    • 20% survival rate following complete resection of metastases at other sites.

Survival for patients with unresectable metastatic disease is less than 5%

Factors that suggest a better outcome include

  • fewer pulmonary nodules
  • Unilateral pulmonary metastases
  • Longer intervals between primary tumor resection and recurrence.


The chest X-ray below shows that the patient had a previous right sided pneumonectomy (#2) for metastatic disease (the right hemithorax is opaque and the trachea is pulled towards the right) and now unfortunately has a left sided hilar mass (#1) - due to further recurrent osteogenic sarcoma.


Recurrent disease in bone:

  • Patients with osteosarcoma who develop bone metastases have a poor prognosis. In one large series, the 5-year event-free survival (EFS) rate was 11%.
  • Patients with late solitary bone relapse have a 5-year EFS rate of approximately 30%.

Link: Recurrent OS at the NCI

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