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. 2022 Feb 22;6(2):e22.00009.
doi: 10.5435/JAAOSGlobal-D-22-00009.

Characteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database

Taylor D Ottesen  1 , Blake N Shultz, Alana M Munger, Cosmas Sibindi, Alp Yurter, Arya G Varthi, Jonathan N Grauer
Affiliations

Characteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database

Taylor D Ottesen et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Introduction: Previous studies about osteosarcoma patient characteristics, management, and outcomes have limited patient numbers, combine varied tumor types, and/or are older studies.

Methods: Patients with osteosarcoma from the 2004 to 2015 National Cancer Database data sets were separated into axial, appendicular, and other. Demographic and treatment data as well as 1-, 5-, and 10-year survival were determined for each group. A multivariate Cox analysis of patient variables with the likelihood of death was performed, and the Kaplan Meier survival curves were generated.

Results: Four thousand four hundred thirty patients with osteosarcoma (3,435 appendicular, 810 axial, and 185 other) showed survival at 1-year, 5-year, and 10-year and was highest among the appendicular cohort (91.17%, 64.43%, and 58.58%, respectively). No change in survival was seen over the periods studied. The likelihood of death was greater with increasing age category, distant metastases, and treatment with radiation alone but less with appendicular primary site, treatment with surgery alone, or surgery plus chemotherapy.

Discussion: Despite advances in tumor management, surgical excision remains the best predictor of survival for osteosarcomas. No difference was observed in patient survival from 2004 to 2015 and, as would be expected, distant metastases were a poor prognostic sign, as was increasing age, male sex, and axial location.

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Conflict of interest statement

Dr. J. N. Grauer or an immediate family member has received or may receive payments or benefits, during the study period, in an amount of USD less than USD 10,000 from TIDI products (Neenah, WI) and in an amount of USD 10,000 to USD 100,000 from the North American Spine Society (Burr Ridge, IL), and is a member of the board of the Lumbar Spine Research Society (Oregon, WI). None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ottesen, Shultz, Dr. Munger, Sibindi, Yurter, Dr. Varthi, and Dr. Grauer.

Figures

Figure 1
Figure 1
Chart showing the long-term survival of all patients with and without distant metastases at the time of presentation (P < 0.001).
Figure 2
Figure 2
Chart showing the long-term survival of patients in the axial, appendicular, and other cohorts (P < 0.001).
Figure 3
Figure 3
Chart showing the long-term survival of patients in the 3 era groups (P = 0.220)
See this image and copyright information in PMC

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