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Tumor Volume Increase During Preoperative Chemotherapy as a Novel Predictor of Local Recurrence in Extremity Osteosarcoma

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Known risk factors (surgical margin, tumor necrosis) of local recurrence (LR) in osteosarcoma are determined by results available after surgery. However, relations between preoperative characteristics and LR have not been clearly defined.

Methods

We compared the clinicopathologic characteristics of 36 osteosarcoma patients with LR and 394 patients without LR after surgery. In addition, prognostic variables were evaluated to establish factors could influence LR.

Results

Compared to the non-LR group, the LR group showed an increase in tumor volume ratio (TVR) during preoperative chemotherapy (P < 0.01), inadequate surgical margin (P < 0.01), and poor histologic response (P < 0.01). Univariate analysis of data from 430 patients revealed that an increased TVR (P < 0.01), inadequate surgical margin (P < 0.01), poor histologic response (P < 0.01), and nonosteoblastic pathologic subtype (P = 0.04) were negatively related to LR-free survival. In multivariate analysis, an elevated TVR (P < 0.01, relative risk = 10.26) and inadequate surgical margin (P < 0.01, relative risk = 5.91) emerged as the key prognostic factors for LR.

Conclusions

A TVR increase during preoperative chemotherapy could be used to predict patients at high risk of LR. This finding might be useful when considering surgical options to decrease the risk of LR.

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Conflict of interest

The authors certify that they have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might constitute a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea

    Won Seok Song MD, Dae-Geun Jeon MD, Chang-Bae Kong MD, Wan Hyeong Cho MD & Soo-Yong Lee MD

  2. Department Pathology, Korea Cancer Center Hospital, Seoul, Korea

    Jae-Soo Koh MD

  3. Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea

    Jun Ah Lee MD

  4. Department of Radiology, Korea Cancer Center Hospital, Seoul, Korea

    Ji Young Yoo MD

  5. Department of Orthopedic Surgery, Chonnam National University Medical School, Gwangju, Korea

    Sung Taek Jung MD

  6. Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea

    Duk Seop Shin MD

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  1. Won Seok Song MD
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  2. Dae-Geun Jeon MD
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Correspondence to Dae-Geun Jeon MD.

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Song, W.S., Jeon, DG., Kong, CB. et al. Tumor Volume Increase During Preoperative Chemotherapy as a Novel Predictor of Local Recurrence in Extremity Osteosarcoma. Ann Surg Oncol 18, 1710–1716 (2011). https://doi.org/10.1245/s10434-010-1536-8

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  • DOI: https://doi.org/10.1245/s10434-010-1536-8

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