A study of 28 flat bone osteosarcomas: prognostic factors and early and long-term outcome (original) (raw)

Prognostic factors and survival rate of osteosarcoma: A single-institution study

Asia-Pacific Journal of Clinical Oncology, 2015

Aim: Osteosarcoma is a highly malignant primary bone tumor. The study aim to evaluate the prognostic factors influencing the survival rate in our center. Methods: This was a retrospective cohort study of all patients treated between January 2005 and December 2010. Results: We included 163 patients with an age range of 6-59 years (median = 19). The median follow-up was 47 months (range 36-84). The overall survival in patients who completed chemotherapy and surgery (n = 117) was 72% at 2 years and 44% at 5 years. Histologically, 99 (85%) had osteoblastic, 6 (5%) had chondroblastic and 3 (2.5%) had telangiectatic osteosarcoma. Limb salvage surgery was performed in 80 (49%) and 41 (25%) underwent amputation. However, 46 patients (28%) underwent no surgical intervention and incomplete chemotherapy. In total, 38/79 patients had a good chemotherapy response. There was a significantly better survival rate for limb salvage versus amputation. Independent prognostic factors for survival are compliance to treatment and presence of lung metastasis. Conclusion: The overall survival of osteosarcoma patients was influenced by the presence of pulmonary metastases and compliance to treatment. Histological subtype, different chemotherapy regimens and histological necrosis after chemotherapy did not significantly influence survival. The patients who did not complete treatment had significantly poorer survival.

Long-term survivals of stage IIb osteosarcoma: a 20-year experience in a single institution

Clinics in orthopedic surgery, 2011

The purpose of this study is to evaluate the disease-free survival (DFS) and overall survival (OS) of patients with stage IIB osteosarcoma at a single institution for 20 years and to compare the results according to the chemotherapy protocols. From Jan 1988 to Nov 2008, 167 patients with osteosarcoma were treated at our hospital and among them, 117 patients (67 males and 50 females) with stage IIB osteosarcoma were evaluable. Their mean age was 22.6 years (range, 8 months to 71 years). Seventy-eight cases underwent the modified T10 (M-T10) protocol (group 1), 23 cases underwent the T20 protocol (group 2) and 16 cases underwent the T12 protocol (group 3). The DFS and OS were calculated and compared according to the chemotherapy protocols. At a mean follow-up of 78.9 months, 63 patients were continuously disease-free (63/117), 6 patients were alive after having metastatic lesions, 7 patients died of other cause and 41 patients died of their disease. The 5- and 10-year OS rates were 60...

Osteosarcoma: improvement in survival limited to high-grade patients only

Journal of Cancer Research and Clinical Oncology, 2011

Background We sought to identify the significant prognostic parameters of patients with osteosarcoma over the past three decades using a population-based registry. Methods A total of 3765 patients with osteosarcoma were identified in the SEER database. Information regarding patient demographics, clinical and treatment characteristics, cause of death and survival were extracted. Kaplan-Meier, Log-Rank, and Cox regression were used for analysis. Results On multivariate analysis only age group '\25 years', 'local' stage and 'low' grade, 'appendicular skeleton' and employment of 'surgical resection' showed a disease-specific survival benefit with a P value \ 0.001. The long-term survival improved in the interval from 1973 to 1985 from approximately 55 to 65% but subsequent improvement has been limited only to patients with highgrade disease. Conclusion When comparing survival rates by decade of diagnosis, it appears that improvement in survival since 1985 is limited to patients with high-grade disease only. Level of evidence The level of evidence for this article is 2.

Survival Data for 648 Patients with Osteosarcoma Treated at One Institution

Clinical Orthopaedics and Related Research, 2004

During the past 30 years, the orthopaedic oncology group at the Massachusetts General Hospital has treated 648 patients with osteosarcoma centrally located in the bone. Using records maintained in a specifically designed computer system, a study was done to assess the factors that seemed to influence the survival outcome. The overall survival for the entire series was 68% at an average followup of 6 ± 4 years. Death occurred at a mean of 3 ± 3 years. Patient gender had no effect, but age of the patient was correlated with survival data, with the poorest survival for the older patients. Surgical treatment had no effect on outcome, but the Musculoskeletal Tumor Society stage of the lesion, the presence of metastases or local recurrence, and the chemotherapeutic treatment (very dependent on the drugs available and adjuvant versus neoadjuvant administration at various decades) all had a profound effect. In addition, anatomic location, size of the tumor, and percentage of tumor cells killed after neoadjuvant chemotherapy all had an effect on outcome.

Changing Prognostic Factors in Osteosarcoma: Analysis of 381 Cases from Two Institutions

Human Pathology, 2014

Osteosarcoma occurs most commonly in children and young adults, with a historic second incidence peak in the elderly. Most studies have focused on those occurring in adolescence. Detailed information on descriptive features and prognostic factors in patients of different age groups is lacking. We analyzed 381 osteosarcomas diagnosed between 1973 and 2012 to identify factors significantly associated with survival in various age groups. The peak incidence was seen in patients age <25, followed by a steady incidence rate thereafter until the sixth decade, when it started to decline. In the early-onset diseases, significant factors for recurrence free survival (RFS) were tumor site and size; whereas those for overall survival (OS) were gender, tumor site, type, grade and size. In patients age 25-54, tumor type and grade were significant for RFS, and the pathologic type was significant for OS. In those age ≥55, race and tumor size were significant for RFS; tumor site and size were significant for OS. In multivariate analysis, tumor size remained significant for RFS; gender, tumor site and size maintained their significance for OS in patients age <25. While no independent factor was identified in patients age 25-54, tumor size remained significant for RFS in those age ≥55.

Prognostic factors and outcomes for osteosarcoma: An international collaboration

European Journal of Cancer, 2009

We aimed to evaluate the prognostic significance of traditional clinical predictors in osteosarcoma through an international collaboration of 10 teams of investigators (2680 patients) who participated. In multivariate models the mortality risk increased with older age, presence of metastatic disease at diagnosis, development of local recurrence when the patient was first seen, use of amputation instead of limb salvage/wide resection, employment of unusual treatments, use of chemotherapeutic regimens other than anthracycline and platinum and use of methotrexate. It was also influenced by the site of the tumour. The risk of metastasis increased when metastatic disease was present at the time the patient was first seen and also increased with use of amputation or unusual treatment combinations or chemotherapy regimens not including anthracycline and platinum. Local recurrence risk was higher in older patients, in those who had local recurrence when first seen and when no anthracycline and platinum were used in chemotherapy. Results were 0959-8049/$ -see front matter Ó

TEN YEARS EXPERIENCE IN OSTEOSARCOMA; ANALYSIS AND TREATMENT RESULTS IN ALEXANDRIA; (2003- 2012)

Background: This study reviewed medical records of Osteosarcoma patients presented to Alexandria Clinical Oncology Department (ACOD) and Sporting Health Insurance Hospital between January 2003 and December 2012. Methods: A total of 87 patients were included in this study. Medical records were retrospectively reviewed and data were retrieved as regards epidemiologic aspects, clinicopathological details, staging, treatment modalities, treatment side effects and survival outcome. Results: Most of patients presented at the age 10-15 years. Females were slightly more affected than males. Most of patients presented at a localized disease stage (stage I, II) (75.85%). Most of the patients had recurrence during their follow up (77.01%) and commonest site was the lungs (77.11%). Median Overall survival (OS) was about 24 months and median Progression Free Survival (PFS) was about 12.17 months, while 3-years OS and PFS were about 35% and 21% respectively. Conclusion: Osteosarcoma survival correlates with primary bone site (axial or peripheral), pathology grade of tumor, stage, tumor size, tumor resection adequacy, response after induction chemotherapy, primary treatment modality. While no significant correlation was seen with age, gender, pathological subtype, and adding radiotherapy line.

Clinical features in osteosarcoma and prognostic implications

Jornal de Pediatria, 2004

Objective: To identify the clinical features in osteosarcoma and to investigate their influence on the prognosis of children and adolescents presenting this disease. Material and methods: The records of children and adolescents with osteosarcoma treated by the Bone Tumors Group of the state of Rio Grande do Sul, Brazil, between January 1992 and December 2001 were reviewed. Results: Fifty consecutive patients were included in this study. Mean age at diagnosis was 13 years (3-22); 68% of the patients were males. The primary site of disease was the femur in 50% of the patients, tibia in 30%, pelvis in 4%, humerus in 10%, fibula in 2% and other sites in 4%. Nineteen patients presented metastases at diagnosis (38%). All patients received chemotherapy and were treated with three different schemes. As for surgical treatment, 26 patients (52%) had an amputation and 17 (34%) received conservative surgery. Serum lactic dehydrogenase > 1,000 UI/ml (p = 0.0159, log rank), tumor necrosis < 90% and presence of metastases had a negative influence on prognosis. The overall 5-year survival was of 33.2±7.2% with mean follow-up of 36 months (6-126). Event-free survival was 29.7±7%. The 5-year event-free survival in non-metastatic patients was 45±10.7%, and zero in metastatic patients (follow-up of 78.4 and 18.7 months, respectively). Only two out of 19 metastatic patients are alive and free of disease at 18 and 30 months respectively. Conclusion: Metastatic disease at diagnosis, serum levels of serum lactic dehydrogenase > 1,000 UI/ml and tumor necrosis < 90% are predictors of unfavorable prognosis. The excessively high incidence of metastatic patients may suggest the presence of an aggressive pattern of disease in our population, or may indicate late diagnosis.