Abstract
Objective
The aim of this study was to identify prognostic factors and imply the appropriate management for local recurrent osteosarcoma.
Methods
The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010. The mean followed-up time for these patients was 49.1 months (range 13 to 143 months). The factors of age, gender, tumor site, tumor size, surgical procedure, neoadjuvant chemotherapy, frequency of primary postoperative adjuvant chemotherapy, lung metastasis, metastasis of other sites (except for lung) and treatment after local recurrence were selected as the measurements for this analysis. Kaplan-Meier method was used to measure the overall survival and post-recurrence survival. The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test. The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival.
Results
The median post-recurrence survival and overall survival of 60 patients were 32 months (95% confidence interval: 16.2–47.8) and 55 months (95% confidence interval: 39.3–70.7) respectively. The 2- and 3-year cumulative survival rates were 81.7% and 55.4%, respectively. The Log-rank univariate analysis showed that age, gender, tumor size, metastasis of other sites (except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence (P < 0.05). The Cox regression analysis revealed that gender (P = 0.016), metastasis of other sites (except for lung, P = 0.017) and treatment after local recurrence (P = 0.028) were the independent prognostic factors of osteosarcoma with local recurrence. On the other hand, the prognosis of local recurrent osteosarcoma was not associated with tumor site, surgical procedure, frequency of primary postoperative adjuvant chemotherapy, neoadjuvant chemotherapy and lung metastasis (P > 0.05).
Conclusion
The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site (except for lung) and the treatment after local recurrence. The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.
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References
Qi WX, He AN, Tang LN, et al. COX proportional-hazard regression analysis of prognostic factors in 52 adult patients with osteosarcoma. Tumor (Chinese), 2011, 31: 846–850.
Provisor AJ, Ettinger LJ, Nachman JB, et al. Treatment of non-metastatic osteosarcoma of the extremity with preoperative and postoperative chemotherapy: a report from Children’s Cancer Group. J Clin Oncol, 1997, 15: 76–84.
Ferrari S, Bertoni F, Mercuri M, et al. Predictive factors of diseasefree survival for non-metastatic osteosarcoma of the extremity: Analysis of 300 patients treated at the Rizzoli Institute. Ann Oncol, 2001, 12: 1145–1150.
Bacci G, Ferrari S, Mercuri M, et al. Predictive factors for local recurrence in osteosarcoma: 540 patients with extremity tumors followed for minimum 2.5 years after neo-adjuvant chemotherapy. Acta Orthop Scand, 1998, 69: 230–236.
Chou AJ, Merola PR, Wexler LH, et al. Treatment of osteosarcoma at first recurrence after contemporary therapy: the Memorial Sloan-Kettering Cancer Center experience. Cancer, 2005, 104: 2214–2221.
Bacci G, Longhi A, Versari M, et al. Prognostic factors for osteosarcoma of the extremity treated with neo-adjuvant chemotherapy: 15-year experience in 789 patients treated at a single institution. Cancer, 2006, l06: 1154–1161.
Ozaki T, Flege S, Kevric M, et al. Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group. J Clin Oncol, 2003, 21: 334–341.
Kawai A, Huvos AG, Meyers PA, et al. Osteosarcoma of the pelvis. Oncologic results of 40 patients. Clin Orthop Relat Res, 1998, 348: 196–207.
Picci P, Sangiorgi L, Rougraff BT, et al. Relationship of chemotherapy-induced necrosis and surgical margins to local recurrence in osteosarcoma. J Clin Oncol, 1994, 12: 2699–2705.
Bielack SS, Kempf-Bielack B, Winkler K. Osteosarcoma: relationship of response to preoperative chemotherapy and type of surgery to local recurrence. J Clin Oncol, 1996, 14: 683–684.
Bacci G, Forni C, Longhi A, et al. Local recurrence and local control of nonmetastatic osteosarcoma of the extremities: a 27-year experience in a single institution. J Surg Oncol, 2007, 96: 118–123.
Jiang ZM, Zhang HZ, Chen JQ, et al. Histological type of Osteosarcoma. J Clin Exp Pathol (Chinese), 2004, 20: 263–266.
Andreou D, Bielack SS, Carrle D, et al. The influence of tumor and treatment-related factors on the development of local recurrence in osteosarcoma after adequate surgery. An analysis of 1355 patients treated on neo-adjuvant Cooperative Osteosarcoma Study Group protocols. Ann Oncol 2011, 22: 1228–1235.
Bacci G, Longhi A, Cesari M, et al. Influence of local recurrence on survival in patients with extremity osteosarcoma treated with neo-adjuvant chemotherapy: the experience of a single institution with 44 patients. Cancer, 2006, 106: 2701–2706.
Liu HH, Huang XY. Telangiectatic osteosarcoma: a clinicopathologic analysis of 14 cases. Chin J Pathol (Chinese), 2002, 31: 213–216.
Matsuno T, Unni KK, McLeod RA, et al. Telangiectatic osteogenic sarcoma. Cancer, 1976, 38: 2538–2547.
Lindell MM Jr, Shirkhoda A, Raymond AK, et al. Parosteal osteosar-coma: adiologic-pathologic correlation with emphasis on CT. AJR Am J Roengtenol, 1987, 148: 323–328.
Ding Y, Cai YB, Zhang Q. Parosteal osteosarcoma: a clinical study of 48 cases. Chin J Surg (Chinese), 2003, 41: 832–836.
Qi WX, Shen Z, Tang L, et al. Comparison between preadolescent and adolescent patients with high-grade osteosarcoma in China. Chinese-German J Clin Oncol, 2012, 11: 274–278.
Smeland S, Müller C, Alvegard TA, et al. Scandinavian Sarcoma Group Osteosarcoma Study SSG VIII: prognostic factors for outcome and the role of replacement salvage chemotherapy for poor histological responders. Eur J Cancer, 2003, 39: 488–494.
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Sha, J., Qi, W., Hu, H. et al. Retrospective analysis of prognostic factors for sixty osteosarcoma patients with local recurrence. Chin. -Ger. J. Clin. Oncol. 12, 123–128 (2013). https://doi.org/10.1007/s10330-012-1135-1
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DOI: https://doi.org/10.1007/s10330-012-1135-1