Prognostic factors for survival in patients with high-grade osteosarcoma using the Surveillance, Epidemiology, and End Results (SEER) Program database

Abstract

Background: The current study aims to determine cause-specific survival in patients with high-grade osteosarcoma while reporting risk factors for decreased survival out to 10 years.

Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify all patients diagnosed with high-grade osteosarcoma from 1991 to 2010. Patient, tumor, and county-level socioeconomic measures were analyzed to determine prognostic factors for survival.

Results: Cause-specific 10-year survival for patients with local/regional disease at the time of diagnosis was 65.8%, compared to 24.0% for patients with metastatic disease. Multivariate analysis revealed metastatic disease at presentation, age≥60 years, male sex, axial location, and size≥10cm as independent risk factors for decreased cause-specific survival at 10 years. Patients with the lowest socioeconomic status had a disproportionate frequency of metastatic disease and large tumors at presentation as compared to more affluent patients.

Conclusions: Patients with high-grade osteosarcoma have decreased cause-specific survival at 10 years when metastatic at diagnosis, patient age≥60 years, male sex, axial tumor location, and tumors measuring≥10cm. Patients living in low socioeconomic counties present more frequently with metastatic disease and large tumors. Public health efforts should focus on identifying patients with osteosarcoma prior to metastasis.

Keywords: Bone neoplasms/mortality; Risk factors; SEER Program; Sarcoma, Osteosarcoma/mortality; Survival analysis.