Sex, Age and Surviving Cancer

Osteosarcoma survival higher in females than males

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) A rare form of bone cancer, osteosarcoma, develops in about 800 Americans a year. A new study looked at how an individual’s sex and age affect survival.

Treatment for osteosarcoma involves surgery and chemotherapy, which can be given before and after surgery.

Researchers have found that female osteosarcoma patients tended to live longer than male patients.

This study also found that children and adolescents had slightly better outcomes than adults. 

"If your child complains of bone pain, see a doctor.

Marnie Collins, BCom, BSc, of the Peter MacCallum Cancer Centre and Australasian Sarcoma Study Group in Melbourne, Australia, led an international effort to review previous studies evaluating osteosarcoma treatment response.

These researchers were looking to see if age and sex influence chemotherapy response and toxicities in osteosarcoma, a disease that strikes children, adolescents, young adults and adults.

"It has long been recognized that outcomes in bone and soft tissue sarcomas vary by age at diagnosis," Robert Canter, MD, MAS, FACS, associate professor of surgery at the University of California, Davis School of Medicine, told dailyRx News.

"As a general rule, children with bone and soft tissue sarcomas have a more favorable prognosis than adults, leading many to speculate about potential differences in biology and/or treatment between children and adults as the etiology [origin] of these differences," said Dr. Canter, who was not involved in this analysis.

After reviewing data from the 24 studies, the researchers uncovered the following:

  • 10-year survival was higher in females than in males — 66 percent versus 61 percent.
  • Children and adolescents had slightly better outcomes than adults.
  • Females were more likely than males to develop serious side effects involving low blood cell counts as a result of the chemotherapy — 63 percent versus 53 percent.
  • Adolescents and adults had fewer serious blood side effects than children — 54 percent versus 67 percent.
  • Children were more likely to die of toxicity than adolescents and adults.

"These results suggest fundamental differences in the way chemotherapy is handled by females compared with males and by children compared with older populations. These differences may influence survival in a disease in which chemotherapy is critical to overall outcomes," the authors of this study wrote.

Dr. Canter explained these results: "The authors of the present study confirm an association between childhood diagnosis and improved survival for osteosarcoma patients and, interestingly, they also demonstrate improved survival and worse toxicity from chemotherapy among females and children."

"These results suggest that favorable response to and toxicity from chemotherapy are biologically linked in osteosarcoma and therefore important for outcome," Dr. Canter said. "Although these represent significant findings, more study is needed to determine the optimal dose-response relationship of chemotherapy for individual sarcoma patients of all age groups."

Findings from this study were published June 20 in the Journal of Clinical Oncology

The research was supported by Victorian Cancer Agency Clinical Research Fellowship, the LIVESTRONG Foundation LIVESTRONG Young Adult Alliance, the Australasian Sarcoma Study Group, Deutsche Krebshilfe, the European Union's FP7 European Network for Cancer Research in Children and Adolescents and the Förderkreis Krebskranke Kinder Stuttgart.

Study co-author Stefan Bielack disclosed ties to Bayer Pharmaceuticals, IDM Pharma/Takeda Pharmaceutical and Merck. Study co-author Archie Bleyer disclosed ties to Sigma-Tau Pharmaceuticals.

Review Date: 
June 20, 2013
Last Updated:
December 30, 2013