Malignant bone tumors are commonly classified as pediatric or adolescent malignancies, and clinical trials for these diseases have generally focused on these populations. Of primary bone cancers, osteosarcoma is among the most common. Osteosarcoma has a bimodal age distribution, with the first peak occurring in patients from 10 to 14 years old, and the second peak occurring in patients older than 65, with about 25% of cases occurring in adults between 20 and 59 years old. Notably, adult osteosarcoma patients have worse outcomes than their pediatric counterparts. It remains unclear whether age itself is a poor prognostic factor, or if inherent differences in tumor biology exist between age groups. Despite these unknowns, current treatment strategies for adults are largely extrapolated from pediatric studies since the majority of clinical trials for osteosarcoma treatments are based on younger patient populations. In light of the different prognoses observed in pediatric and adult osteosarcoma, we summarize the current understanding of the molecular etiology of osteosarcoma and how it may differ between age groups, hypothesizing why adult patients have worse outcomes compared to children.
恶性骨肿瘤通常被归类为儿童或青少年恶性肿瘤，相关临床试验也主要针对这些人群。在原发性骨癌中，骨肉瘤属于最常见类型之一。骨肉瘤的年龄分布呈现双峰特征：第一个高峰出现在10至14岁的患者中，第二个高峰则出现在65岁以上的患者中，约25%的病例发生在20至59岁的成年人群中。值得注意的是，成年骨肉瘤患者的预后较儿童患者更差。目前尚不清楚年龄本身是否为不良预后因素，亦或不同年龄组间存在肿瘤生物学特性的本质差异。尽管存在这些未知因素，由于大多数骨肉瘤治疗的临床试验基于年轻患者群体，当前针对成年患者的治疗策略主要从儿科研究中推导得出。鉴于儿童与成年骨肉瘤患者预后的显著差异，本文综述了当前对骨肉瘤分子病因学的认识，探讨其在不同年龄组间的潜在差异，并对成年患者预后较差的可能机制提出理论假设。
Osteosarcoma in Pediatric and Adult Populations: Are Adults Just Big Kids?
肿瘤(癌症)患者之家