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. 2009;64(12):1177-86.
doi: 10.1590/S1807-59322009001200007.

Prognostic factors in the survival of patients diagnosed with primary non-metastatic osteosarcoma with a poor response to neoadjuvant chemotherapy

Rosalvo Zósimo Bispo Júnior  1 , Olavo Pires de Camargo
Affiliations

Prognostic factors in the survival of patients diagnosed with primary non-metastatic osteosarcoma with a poor response to neoadjuvant chemotherapy

Rosalvo Zósimo Bispo Júnior et al. Clinics (Sao Paulo). 2009.

Abstract

Introduction: Identification of variables that determine the prognosis for osteosarcoma may enable stratification of patients into subgroups with better or worse risk of local recurrence, metastases and death due to the disease. Discovery of such prognostic factors would permit selection of a subgroup of at-risk patients, with the aim of improving the therapeutic effectiveness.

Objective: To identify prognostic factors related to local recurrence-free survival, metastasis-free survival and overall survival among patients with highly malignant primary osteosarcoma that was non-metastatic on diagnosis and had poor response to neoadjuvant chemotherapy.

Sample and methods: Out of 45 patients admitted to a referral center in Brazil between 2000 and 2004, 24 were selected for this study.

Results: The adverse factors that influenced the risk of local recurrence and the overall survival in univariate analysis were histological subtype other than osteoblastic (p = 0.017) and tumor size greater than 15 cm (p = 0.048). In relation to metastasis-free survival, the non-osteoblastic subtype had a worse prognosis (p = 0.007). The association of histological subtype maintained its significance in multivariate analysis for all studied survival categories.

Conclusions: Tumor size greater than 15 cm is an adverse factor for local recurrence-free survival and overall survival but did not influence metastasis-free survival. The osteosarcoma histological type is a significant independent predictor for local recurrence-free survival, metastasis-free survival and overall survival.

Keywords: Bone neoplasms; Drug therapy; Epidemiology; Pathology; Surgery.

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Figures

Figure 1
Figure 1
Magnetic resonance images demonstrating the tumor expansion process (osteosarcoma) in the distal metaphysis and epiphysis of the left femur and affecting soft tissues (extra-compartmental). Coronal (A) and axial (B) T1 images
Figure 2
Figure 2
Photomicrograph showing the telangiectasia type of osteosarcoma (non-osteoblastic) (200 X- HE)
Figure 3
Figure 3
Intraoperative photograph showing a wide tumor resection in the distal region of the left femur
Figure 4
Figure 4
Radiograph showing a lateral view of the knee region, in which osteoarticular substitution using an unconventional modular endoprosthesis can be seen
Figure 5
Figure 5
Curve of local recurrence-free survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis
Figure 6
Figure 6
Curve of local recurrence-free survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis, according to histological type
Figure 7
Figure 7
Curve of local recurrence-free survival in months for the 23 patients with primary osteosarcoma that was non-metastatic at diagnosis, according to tumor size
Figure 8
Figure 8
Curve of metastasis-free survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis
Figure 9
Figure 9
Curve of metastasis-free survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis, according to histological type
Figure 10
Figure 10
Curve of overall survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis
Figure 11
Figure 11
Curve of overall survival in months for the 24 patients with primary osteosarcoma that was non-metastatic at diagnosis, according to histological type
Figure 12
Figure 12
Curve of overall survival in months for the 23 patients with primary osteosarcoma that was non-metastatic at diagnosis, according to tumor size
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