ArticlePediatric blood & cancer2024
Long-term outcomes among survivors of childhood osteosarcoma: A report from the Childhood Cancer Survivor Study (CCSS).
Article in Pediatric blood & cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Evaluating the Impact of Habitat Analysis via IVIM and DCE-MRI on Neoadjuvant Chemotherapy Outcomes in Osteosarcoma Patients: A Preliminary Study.Journal of imaging informatics in medicine · 2026Article
- Comedication that increase the risk of cisplatin-induced hearing loss in pediatric cancer patients: a narrative literature review and meta-analysis.Frontiers in oncology · 2026Review
- Current Strategies for Limb Salvage and Reconstruction in Pediatric Lower Extremity Malignant Bone Tumors: Focus on Growth Preservation and Functional Outcomes.Children (Basel, Switzerland) · 2025Review
- Sarcoma: Cardiovascular and Oncologic Considerations: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2025Review
- [Reconstruction of bone defects after resection of osteosarcoma in children with artificial hemi-knee prosthesis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Can We Accurately Predict Adult Height in Pediatric Patients Who Undergo Treatment for Sarcoma?Clinical orthopaedics and related research · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
purposeTreatment strategies for osteosarcoma evolving between 1970 and 1999 improved 5-year survival and continue as standard of care today. This report evaluates the impact of these evolving therapies on long-term health outcomes.
methodsFive-year survivors of childhood osteosarcoma in CCSS treated from 1970 to 1999 were evaluated for late (>5 years from diagnosis) mortality, chronic health conditions (CHCs), and health status using piecewise-exponential and logistical models. Comparisons were made between survivors and siblings without cancer, and among survivors examining historical and current standard chemotherapies (e.g., methotrexate/doxorubicin/cisplatin [MAP] vs. others), specific chemotherapy agents and surgical approaches (amputation vs. limb salvage [LS]). Models were evaluated adjusting for attained age, sex, race, ethnicity, and age at diagnosis.
resultsA total of 1257 survivors of osteosarcoma were followed on average for 24.4 years. Twenty-year all-cause late mortality was 13.3% (95% confidence interval [CI]: 11.7%-14.9%) overall and 11.7% (95% CI: 6.9%-16.5%) for the subset treated with MAP plus LS. Survivors were at higher risk of CHCs (rate ratio [RR] 3.7, 95% CI: 3.2-4.3) than the sibling cohort, most notably having more serious cardiac, musculoskeletal, and hearing CHCs. Within the survivor cohort, the risk of severe CHCs was twice as high with MAP versus no chemotherapy (RR 2.1, 95% CI: 1.3-3.4). Compared with primary amputation, serious musculoskeletal CHCs were higher after LS (RR 6.6, 95% CI: 3.6-13.4), without discernable differences in health status.
conclusionContemporary osteosarcoma therapy with MAP plus LS, while improving 5-year disease-free survival, continues to be associated with a high burden of late mortality, CHCs, and health status limitations.
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