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. 2013 Aug 15;8(8):e71362.
doi: 10.1371/journal.pone.0071362. eCollection 2013.

Prognostic value of histological response to chemotherapy in osteosarcoma patients receiving tumor-bearing frozen autograft

Shinji Miwa  1 , Akihiko Takeuchi, Hiroko Ikeda, Toshiharu Shirai, Norio Yamamoto, Hideji Nishida, Katsuhiro Hayashi, Yoshikazu Tanzawa, Hiroaki Kimura, Kentaro Igarashi, Hiroyuki Tsuchiya
Affiliations

Prognostic value of histological response to chemotherapy in osteosarcoma patients receiving tumor-bearing frozen autograft

Shinji Miwa et al. PLoS One. .

Abstract

Background: A variety of surgical procedures are now available for tissue reconstruction after osteosarcoma excision, and an important prognostic factor is the evaluation of response to chemotherapy using histology. Although tumor-bearing autografts are useful tools for reconstruction, re-use of the primary tumor may make it difficult to assess the histological response to chemotherapy, since the entire tumor cannot be analyzed. Here, we analyzed the prognostic value of the histological response in the patients who received frozen tumor-bearing autografts for reconstruction.

Method: Retrospective analysis of the medical records of 51 patients with high-grade osteosarcoma of the extremities was performed. All patients received reconstruction using frozen tumor-bearing autografts. Tumor necrosis was evaluated in extraskeletal masses and cancellous bone.

Results: Five-year overall survival of patients with good and poor response to chemotherapy was 82.9% and 46.4%, respectively (P = 0.044), and 5-year event-free survival was 57.7% and 36.0%, respectively (P = 0.329). Multivariate analysis revealed that a poor histological response to chemotherapy was a significant prognostic factor for overall survival (P = 0.033).

Conclusion: Histological response is an important and reliable prognostic factor in patients undergoing reconstruction using frozen tumor-bearing autografts.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Procedure of reconstruction with frozen autograft and assessment of chemotherapeutic effect.
Figure 2
Figure 2. Overall and event-free survival of all 51 patients.
Figure 3
Figure 3. Kaplan-Meier curves of overall survival for variables with prognostic significance in univariate analyses.
a. Metastatic lesion. b. Histological response.
Figure 4
Figure 4. Kaplan-Meier curves of overall survival and event-free survival for histological response in patients with or without metastasis.
a. Patients without metastasis. b. Patients with metastases.
See this image and copyright information in PMC

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