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An evaluation of the response to neoadjuvant chemotherapy for osteosarcoma of extremities: PERCIST versus RECIST 1.1 criteria after long-term follow-up

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A Correction to this article was published on 25 June 2022

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Abstract

Objective

The aim of this study was to compare the recent Positron emission tomography (PET) Response Criteria in Solid Tumors (PERCIST) and Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria for evaluating the response of osteosarcoma to neoadjuvant chemotherapy of the extremities.

Methods

We retrospectively reviewed patients with osteosarcoma of the extremities who received neoadjuvant chemotherapy and then surgical resection at Peking University People’s Hospital. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) were performed prior to chemotherapy and before surgical resection. Therapeutic response was assessed separately by the PERCIST and RECIST 1.1 criteria. The association between the data acquired by the PERCIST and RECIST 1.1 criteria was then analyzed by Wilcoxon’s signed-rank test. The association between the PERCIST criteria and the pathological necrosis rate was analyzed by Fisher’s exact test. Finally, the impact of a range of clinicopathological factors on overall survival (OS) and event-free survival (EFS) was analyzed by Cox proportional hazards regression.

Results

We recruited 68 patients with a median follow-up of 74 months (range 45–102 months). The evaluations resulting from the RECIST 1.1 and PERCIST criteria were significantly different (p = 0.000). Only two responders were identified according to the RECIST 1.1 criteria. However, 34 responders were identified by the PERCIST criteria. Data arising from the PERCIST criteria were in accordance with the pathological necrosis rate. Survival analysis showed that metastasis at diagnosis, poor pathological response, and disease progression (according to the RECIST 1.1 or PERCIST criteria) were all associated with a poor prognosis (p < 0.05).

Conclusion

Our data indicate that the PERCIST criteria are significantly more sensitive than RECIST 1.1 criteria to identify more responders when evaluating the response of osteosarcoma to neoadjuvant chemotherapy.

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Acknowledgements

We thank Dr Kunkun Sun and Dr Danhua Shen in the pathology department at Peking University People’s Hospital for their review of all pathologic slides.

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Authors and Affiliations

  1. Musculoskeletal Tumor Center, Peking University People’s Hospital, 11 Xizhimen South Street, Beijing, China

    Jie Xu, Yuan Li, Lu Xie, Xin Sun, Zhenyu Cai, Shidong Wang, Qian Wang, Kunkun Sun & Wei Guo

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  1. Jie Xu
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  2. Yuan Li
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  3. Lu Xie
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  4. Xin Sun
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  9. Wei Guo
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Correspondence to Wei Guo.

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Xu, J., Li, Y., Xie, L. et al. An evaluation of the response to neoadjuvant chemotherapy for osteosarcoma of extremities: PERCIST versus RECIST 1.1 criteria after long-term follow-up. Ann Nucl Med 36, 553–561 (2022). https://doi.org/10.1007/s12149-022-01737-5

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