Mirabello Lisa, Troisi Rebecca J, Savage Sharon A
Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892, USA.
Cancer. 2009 Apr 1;115(7):1531-43. doi: 10.1002/cncr.24121.
Osteosarcoma, which is the most common primary bone tumor, occurs most frequently in adolescents, but there is a second incidence peak among individuals aged > 60 years. Most osteosarcoma epidemiology studies have been embedded in large analyses of all bone tumors or focused on cases occurring in adolescence. Detailed descriptions of osteosarcoma incidence and survival with direct comparisons among patients of all ages and ethnicities are not available.
Frequency, incidence, and survival rates for 3482 patients with osteosarcoma from the National Cancer Institute's population-based Surveillance, Epidemiology, and End Results (SEER) Program between 1973 and 2004 were investigated by age (ages 0-24 years, 25-59 years, and 60 to > or = 85 years), race, sex, pathology subtype, stage, and anatomic site.
There were large differences in incidence and survival rates by age. There was a high percentage of osteosarcoma with Paget disease and osteosarcoma as a second or later cancer among the elderly. There was a high percentage of osteosarcoma among patients with Paget disease and osteosarcoma as a second or later cancer among the elderly. Tumor site differences among age groups were noted. Survival rates varied by anatomic site and disease stage and did not improve significantly from 1984 to 2004.
This comprehensive, population-based description of osteosarcoma, identified important differences in incidence, survival, pathologic subtype, and anatomic site among age groups, and quantified the impact of osteosarcoma in patients with Paget disease or as a second cancer on incidence and mortality rates. These findings may have implications in understanding osteosarcoma biology and epidemiology.
骨肉瘤是最常见的原发性骨肿瘤,在青少年中发病率最高,但在60岁以上人群中存在第二个发病高峰。大多数骨肉瘤流行病学研究都纳入了对所有骨肿瘤的大型分析中,或者聚焦于青少年期发生的病例。目前尚无关于所有年龄和种族患者之间直接比较的骨肉瘤发病率和生存率的详细描述。
对1973年至2004年间美国国立癌症研究所基于人群的监测、流行病学和最终结果(SEER)计划中3482例骨肉瘤患者的频率、发病率和生存率,按年龄(0至24岁、25至59岁、60至≥85岁)、种族、性别、病理亚型、分期和解剖部位进行了调查。
发病率和生存率在不同年龄组之间存在很大差异。老年人中患有佩吉特病的骨肉瘤以及作为第二或更晚发生癌症的骨肉瘤比例较高。各年龄组之间存在肿瘤部位差异。生存率因解剖部位和疾病分期而异,并且在1984年至2004年间没有显著改善。
这项基于人群的骨肉瘤综合描述,确定了各年龄组在发病率、生存率、病理亚型和解剖部位方面的重要差异,并量化了佩吉特病患者或作为第二种癌症的骨肉瘤对发病率和死亡率的影响。这些发现可能对理解骨肉瘤生物学和流行病学具有启示意义。