title: Osteosarcoma of the mobile spine.
abstract: BACKGROUND
  The aims of this analysis were to investigate features and outcome of high-grade osteosarcomas of the mobile spine.
  
  
  METHODS
  Since 1977, 20 Cooperative Osteosarcoma Study Group patients had a diagnosis of high-grade osteosarcomas of the mobile spine and were included in this retrospective analysis of patient-, tumor- and treatment-related variables and outcome.
  
  
  RESULTS
  The median age was 29 years (range 5-58). Most frequent tumor sites were thoracic and lumbar spine. All but three patients had nonmetastatic disease at diagnosis. Treatment included surgery and chemotherapy for all patients, 13 were also irradiated. Eight patients failed to achieve a macroscopically complete surgical remission (five local, one primary metastases, two both), six died, two are alive, both with radiotherapy. Of 12 patients with complete remission at all sites, three had a recurrence (two local, one metastases) and died. The median follow-up of the 11 survivors was 8.7 years (range 3.1-22.3), 5-year overall and event-free survival rates were 60% and 43%. Age <40 years, nonmetastatic disease at diagnosis and complete remission predicted for better overall survival (OS, P < 0.05).
  
  
  CONCLUSIONS
  Osteosarcomas of the mobile spine are rare. With complete resection (and potentially radiotherapy) and chemotherapy, prognosis may be comparable with that of appendicular osteosarcomas.
authors.affiliation: Cooperative Osteosarcoma Study Group (COSS), Pediatrics 5 (Oncology, Hematology, Immunology; Gastroenterology, Rheumatology, General Pediatrics), Klinikum Stuttgart--Olgahospital, Stuttgart, Germany. coss@olgahospital-stuttgart.de
authors.forename: K
authors.initials: K
authors.lastname: Zils
authors.forename: S
authors.initials: S
authors.lastname: Bielack
authors.forename: M
authors.initials: M
authors.lastname: Wilhelm
authors.forename: M
authors.initials: M
authors.lastname: Werner
authors.forename: R
authors.initials: R
authors.lastname: Schwarz
authors.forename: R
authors.initials: R
authors.lastname: Windhager
authors.forename: G
authors.initials: G
authors.lastname: Hofmann-Wackersreuther
authors.forename: T
authors.initials: T
authors.lastname: Andus
authors.forename: L
authors.initials: L
authors.lastname: Kager
authors.forename: T
authors.initials: T
authors.lastname: Kuehne
authors.forename: P
authors.initials: P
authors.lastname: Reichardt
authors.forename: T
authors.initials: T
authors.lastname: von Kalle
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D012516:Osteosarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D010146:Pain; D012189:Retrospective Studies; D013131:Spine / Q000473:pathology*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: chemotherapy; osteosarcoma; outcome; radiotherapy; spine; surgery