People with a form of bone cancer called osteosarcoma have a good chance of surviving their disease, a new report said.

Publishing their findings in the Journal of Clinical Oncology (Vol. 20, No. 3: 776-790), a group of European researchers said they found that 50% to 60% of their patients were cured by the newest treatments for this cancer.

Osteosarcoma affects about 2,000 people each year in the US. Twenty years ago, this cancer carried a terrible prognosis. Most people died even though they had extensive surgery that usually included amputation.

In the 1970’s and 1980’s chemotherapy was added to the surgery as treatment for osteosarcoma. The chemotherapy was given both before and after surgery. Not only did this improve survival rates, it also led to more limb-sparing surgeries.

The researchers from the Cooperative German-Austrian-Swiss Osteosarcoma Study Group looked at 1,700 patients in their study. Most patients were given chemotherapy before and after surgery.

The chemotherapy lasted anywhere from six to nine months. Surgery was usually done at the mid-point of the chemotherapy — around nine to 18 weeks after it was started.

The researchers followed their patients for an average of five years. Some patients were followed for as long as 19 years. Chemotherapy produced two major effects. First, it improved survival. Half of this large group of patients was cured by their first treatment. Treating a recurrence cured about another 10%.

The other striking effect of chemotherapy was that the rate of amputations dropped from a high of 60% in the early 1980s to around 20% in 1998. This happened because the treatment before surgery shrank the tumor enough so the limb could be spared.

In the past, experts thought that all these benefits went to younger patients. Most patients with osteosarcoma are between 10 and 30 years old. But in this study, older patients were cured just as readily. The only factor that reduced cure rates was where the tumor was found.

Osteosarcomas that developed in the limbs — around 90% in this study – had a good outcome regardless of the patient’s age. But when they started in the trunk, in the pelvic bone, spine or ribs, for instance, the outlook was worse. These patients were cured much less often. This is where age played a role. Older people more often had centrally located cancers.

The bad news is that 40% of patients still died. These patients often didn’t respond well to the initial chemotherapy, or had fast-growing tumors that spread quickly.

In an editorial in the same journal, Paul Meyers, MD, from Memorial Sloan-Kettering Cancer Center in New York, pointed out that this study shows there is a need for new kinds of treatment for those patients with cancers that are either fast-growing or that are not responding well to treatment.

Meyers said that in the long-term, to best address this cancer, drugs that kill cancer cells by targeting specific molecules need to be developed.