[Multivariate analysis for prognostic factors among 43 patients with osteosarcoma]

Abstract

Objective: To determin the prognostic factors that influence survival in patients with osteosarcma.

Methods: The clinical data of 43 patients with osteosarcoma between March 2005 and March 2007 were retrospectively reviewed. Patient's sex, age, tumor site, course of disease, serum alkaline phosphatase (AKP) level, preoperative chemotherapy, Enneking surgical stage, surgical method, distant metastasis were analyzed by Kaplan-Meier method, Log-rank test and COX regression model. Kaplan-Meier method was used to calculate the 3-years survival rate, and Log-rank test was used to determin prognostic factors related with survival rate, and COX regression model was used to find the independent prognostic factors. The effect of neoadjuvant chemotherapy on the prognosis of osteosarcoma was analyzed by Fisher exact test.

Results: All the patients were followed up. Twenty-eight patients were alive, while 15 patients were dead. The survival time ranged from 6 to 65 months with a median survival of 42 months. Overall 3-year survival rate was 65.1%. Univariate analysis revealed that the prognosis of osteosarcoma was significantly related to tumor site (P = 0.010), Enneking surgical stage (P = 0.002), surgical method (P = 0.000) and distant metastasis (P = 0.002). Multivariate analysis by COX regression model suggested Enneking surgical stage (P = 0.028),surgical method (P = 0.001) and distant metastasis (P = 0.007) were the independent prognostic factors. Though the preoperative chemotherapy was unrelated to the survival of osteosarcoma, the sensitivity to preoperative chemotherapy was an important factor that affected the prognosis of osteosarcoma (P = 0.007).

Conclusion: The prognosis of osteosarcoma was significantly correlated with Enneking surgical stage, surgical method and distant metastasis, early detection and wide excision were interventional methods to improve the survival of osteosarcoma.