Prognosis and survival for bone cancer

If you have bone cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether they smoke) that the doctor will consider when making a prognosis.

The following are prognostic factors for bone cancer.

If the cancer has spread

Cancer can spread from the place where it started to other parts of the body. This spread is called metastasis. Whether or not cancer has already spread when it is diagnosed is the most important prognostic factor for bone cancer. Metastasis is linked with a poorer prognosis.

Where the cancer has spread is also an important prognostic factor. Bone cancer that has spread only to the lungs has a better prognosis than metastasis to other parts of the body.

Location of the tumour

Tumours that are found in the bones of the leg or arm (distal tumours) have a better prognosis than tumours that are found in the bones of the pelvis, chest, skull or spine (proximal tumours). This may be because tumours in the arms and legs are easier to completely remove with surgery. Tumours in the chest, pelvis or spine are usually found later, are often larger and are closer to important organs. Those factors make it harder to remove them completely with surgery.

Grade of the tumour

Low-grade tumours have a better prognosis than high-grade tumours.

Size of the tumour

Bone cancer tumours that are smaller than 8 cm have a better prognosis than tumours larger than 8 cm.

Age

People who are younger than 40 when they are diagnosed with bone cancer have a better prognosis than people over age 40.

Response to chemotherapy before surgery

Chemotherapy given before surgery is called neoadjuvant chemotherapy. It is given to make the tumour smaller so it is easier to remove with surgery. It is often used to treat osteosarcoma, the most common type of bone cancer. The amount that a bone cancer tumour shrinks with chemotherapy affects the prognosis. Tumours that respond well and get smaller with chemotherapy have a better prognosis than tumours that do not respond very well to chemotherapy.

Expert review and references

  • American Cancer Society. Bone Cancer. 2016.
  • Bauer HC . Osteosarcoma. Gospodarowicz, M. K., O'Sullivan, B., Sobin, L. H., et al. (Eds.). Prognostic Factors in Cancer. 3rd ed. Hoboken, NJ: John Wiley & Sons, Inc.; 2006: 22: pp. 175-179.
  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.
  • Gerrand C, Athanasou N, BrennanB, et al . UK guidelines for the management of bone sarcomas. Clinical Sarcoma Research. 2016: 6:7.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Bone Cancer (Version 1.2017). 2016.
  • O'Donnell RJ, Dubois SC, Hass-Kogan DA . Sarcomas of bone. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 91:1292–1313.
  • Samuel LC . Bone and soft-tissue sarcoma. Yarbro CH, Wujcik D, Holmes Gobel B (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jones and Bartlett Learning; 2018: 46:1243-1277.

Survival statistics for bone cancer

Survival statistics for bone cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.