Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 1

4094 - Treatment outcomes for adult patients with localized osteosarcoma treated with chemotherapy without methotrexate


28 Sep 2019


Poster Display session 1


Tumour Site



Marília Silva


Annals of Oncology (2019) 30 (suppl_5): v683-v709. 10.1093/annonc/mdz283


M.P..M. Silva1, R.R.D.C.C. Bonadio1, G.D..R. Matos2, V.P. Camargo1

Author affiliations

  • 1 Medical Oncology, ICESP - Instituto do Câncer do Estado de São Paulo, 01426-030 - Sao Paulo/BR
  • 2 Medical Oncology, Hospital Sírio Libanês, 70200-730 - Brasília/BR


Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 4094


In pediatric patients (pts) with localized osteosarcoma, cure rates higher than 60% have been reported. A chemotherapy (CT) regimen frequently suggested as standard in this scenario is the three-drug regimen MAP (methotrexate [MTX], doxorubicin, and cisplatin). However, the addition of MTX remains controversial, especially in adult pts in whom high-grade toxicities are frequent. We aimed to evaluate the outcomes of adult pts with localized osteosarcoma after treatment with CT without MTX.


A single-center cohort of adult pts with high-grade osteosarcoma treated with CT without MTX was retrospectively evaluated. Pts were treated between 2007 and 2018. Overall survival (OS) was calculated from the date of diagnosis to death. Recurrence-free survival (RFS) was time from diagnosis to recurrence or death. Kaplan-Meier method was used for survival analysis. Prognostic factors were evaluated with Cox regression.


A total of 97 consecutive adult pts with osteosarcoma were studied. Median age was 27 years (range 16 – 69). Primary tumor site was extremity in 79.4% of pts (N = 77), and axial in 20.6% (N = 20). Most pts (N = 61; 63%) presented localized resectable disease, while 36 (37%) had unresectable or metastatic disease. Among pts with localized resectable disease, 56 (91%) pts received neoadjuvant/ adjuvant CT without MTX: 48 (86%) received cisplatin and doxorubicin; 8 (14%) received other combinations of cisplatin, doxorubicin, ifosfamide, and/or etoposide. With a median follow-up of 34 months, 3-year and 5-year RFS rates were 42.4% (IC 95% 28 – 55%) and 37.1% (IC 95% 23 – 50%). 3-year and 5-year OS rates were 81.6% (95% CI, 67% – 90%) and 67.3% (95% CI, 48% – 80%). Median RFS and OS were 31.8 months and not reached, respectively. The only factor associated with OS was the number of neoadjuvant/ adjuvant CT cycles (≥ 6 vs < 6 cycles: HR 0.25, 95% CI 0.07 – 0.83, P = 0.025).


Adult pts with localized osteosarcoma treated with CT without MTX had unfavorable survival outcomes in comparison with the literature for pediatric pts. A number of neoadjuvant/ adjuvant CT cycles of 6 or more was associated with superior OS. Improving therapeutic approaches for adult pts is of utmost importance to achieve better results.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.