BACKGROUND: Adult osteosarcoma is extremely rare (approximately 3–5 per million cases per year) and there is little population-based or large case series data reported in the literature. The conduct of an ongoing 10-year surveillance study evaluating potential medication exposures, affords the opportunity to collect information in a large population-based series of adult osteosarcoma patients.
OBJECTIVES: To characterize the demographic, environmental and treatment exposures in adult osteosarcoma patients according to tumor cell type from an ongoing surveillance study. Methods: Incident cases of confirmed primary adult osteosarcoma diagnosed on or after January 1, 2003 are identified through population-based state cancer registries and comprehensive cancer center registries in the US. Once cases are identified and consent is obtained, possible prior treatment with teriparatide, (a self-injectable medication used daily to treat osteoporosis), demographics, and risk factor information is ascertained by patient or proxy telephone interview.
RESULTS: Between June 2004 and December 2006, 430 cases were identified (estimated to be 37% of all adult cases in the US) and 124 cases had interview data. Interviewed cases were similar with regard to mean age, gender, race and geographical distribution compared to non-interviewed cases. Among those interviewed, mean age was 60 years old, 46% were female, 85% were white;and 76% were alive at time case reported to the registry. Osteosarcoma NOS (72%) and Chondroblastic osteosarcoma (11%) were the most common morphology types; leg bones (24%) were the most common tumor site. Reported prevalence of possible known risk factors was: 17% for prior trauma or infection at site of cancer, 10% for history of Paget’s disease, and 19% for history of radiation treatment. Site of prior radiation treatment and site of tumor matched for 18/23 (78%) cases. There have been no valid reports of prior treatment with teriparatide use in this study.
CONCLUSIONS: Data from this ongoing surveillance study are adding to the general knowledge about adult patients with osteosarcoma. Results through the first three years support information from the literature and describe the distribution of risk factors among adult osteosarcoma patients from a population-based case series.
