Time trends in incidence, treatment and survival of children diagnosed with osteosarcoma since the 1990s in the Netherlands: a population-based study.

Abstract

This study examined how often children were diagnosed with osteosarcoma (a type of bone cancer), how they were then treated and how well these patients survived in the Netherlands between 1990-2018. The number of children that received an osteosarcoma diagnosis remained stable over the years and consisted of about 4 cases per million children every year. Most patients were treated with a combination of chemotherapy and surgery, but for patients with for instance a tumor that had already spread treatment sometimes consisted of only chemotherapy and children with a tumor located in central parts of the body received only surgery at times.

The survival of children with osteosarcoma improved over time. In the 1990s, about 57% of patients lived for at least five years after their diagnosis. This increased to 71% in the 2010s and may be related to the fact that patients more often received both chemotherapy and surgery and that osteosarcoma care is more and more centralized in specialized centers. Boys had worse survival outcomes than girls, which might be because boys were more likely to have cancer that had already spread at diagnosis. Teenagers aged 15-17 years also had lower survival rates compared to younger children. Patients whose cancer had already spread at diagnosis had poor survival, with about only 36% of patients still alive 5 years after diagnosis. This is much than patients whose cancer had not spread at diagnosis, where about 73% of patients were still alive after 5 years. This poor survival in patients with advanced disease shows that new and better treatments are needed for specifically this group of children diagnosed with osteosarcoma.

While the study did not include detailed information on things like whether the cancer came back or how patients responded to the chemotherapy, it did give very comprehensive analysis of children diagnosed with osteosarcoma in the Netherlands over almost thirty years. Overall, survival for children with osteosarcoma has improved in the Netherlands, but further improvement is needed, specifically for children with advanced cancer.