Long-term survivors of osteosarcoma may be at risk for neurocognitive impairment related to chronic health conditions, according to a recent study published online ahead of print in JAMA Oncology.1

In a cross-sectional cohort study, Michelle Edelmann, PhD, and fellow researchers at the St. Jude Children’s Research Hospital in Memphis, TN, compared 80 survivors of osteosarcoma with 39 community controls in order to examine neurocognitive, neurobehavioral, emotional and quality of life outcomes.

They found that survivors of osteosarcoma demonstrated lower mean scores in reading skills, attention, memory, and processing speed.

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Upon pharmacokinetic analysis, they also found that high-dose methotrexate maximum plasma concentration, median clearance, and median/cumulative exposure were not associated with neurocognitive outcomes.

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Any grade 3 or 4 Common Terminology Criteria for Adverse Events cardiac, pulmonary, or endocrine condition was associated with poorer memory and slower processing speed, and survivor-reported poor general health was associated with decreased sustained attention and processing speed.

“Prospective longitudinal studies are needed to identify onset and progression of impairment to inform optimal interventions,” the authors concluded.


  1. Edelmann MN, Daryani VM, Bishop MW, et al. Neurocognitive and patient-reported outcomes in adult survivors of childhood osteosarcoma [published online ahead of print November 19, 2015]. JAMA Oncol. doi:10.1001/jamaoncol.2015.4398.