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Prognostic factors for teenage and adult patients with high-grade osteosarcoma: an analysis of 240 patients

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Abstract

The aim of this retrospective, multicenter study was to evaluate clinicopathological characteristics, prognostic factors and treatment outcomes of teenage and adult patients with high-grade osteosarcoma. A total of 240 osteosarcoma patients who were diagnosed and treated from March 1995 to September 2011 were analyzed. Median age was 20 years (range 13–74 years), and 153 patients (63.8 %) were male. Primary tumor localization was extremity in 204 patients (85.4 %), trunk in 21 patients (8.8 %) and head and neck region in 14 patients (5.9 %). According to American Joint Committee on Cancer staging system, 186 patients (77.5 %) were stage II, 3 (1.3 %) were stage III and 48 (20.0 %) were stage IV. Median overall survival (OS) was 55 months (95 % CI 36.8–73.1 months). OS after 2, 5 and 10 years were 67, 49 and 42 %, respectively. Univariable analysis for OS showed that male gender (p = 0.032), high baseline lactate dehydrogenase (LDH) level (p < 0.001), high baseline serum alkaline phosphatase level (p = 0.002), telangiectatic subtype (p = 0.023), presence of metastasis at diagnosis (p < 0.001), presence of tumor positive margins after primary surgery (p = 0.015), poor pathological response to preoperative chemotherapy (p = 0.006) and presence of recurrent disease during follow-up period (p < 0.001) were significantly associated with poor survival. Patients who received postoperative methotrexate plus doxorubicin plus cisplatin (M + A + P) combination regimen (p = 0.019), underwent surgery for recurrent disease (p < 0.001) and received chemotherapy for recurrent disease (p < 0.001) had longer OS. In multivariable analysis for OS, only high LDH level (p = 0.002) and the presence of metastasis at diagnosis (p = 0.011) were associated with poor OS, whereas the patients who received chemotherapy for recurrent disease had a longer OS (p = 0.009).

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Conflict of interest

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Oncology, Dr. A.Y.Ankara Oncology Training and Research Hospital, 13. Street No: 56, Yenimahalle, 06200, Ankara, Turkey

    Ayse Durnali, Necati Alkis, Oznur Bal, Ayse Demirci, Kaan Helvaci & Berna Oksuzoglu

  2. Department of Biostatistics and Medical Informatics, Duzce University Faculty of Medicine, Duzce, Turkey

    Sengul Cangur

  3. Department of Pathology, Dr. A.Y.Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Fisun Ardic Yukruk

  4. Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey

    Ali Inal & Abdurrahman Isikdogan

  5. Department of Medical Oncology, Guven Hospital, Ankara, Turkey

    Saadet Tokluoglu

  6. Department of Medical Oncology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Mehmet Metin Seker

  7. Department of Medical Oncology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Tulay Akman

  8. Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey

    Mevlude Inanc

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  1. Ayse Durnali
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  2. Necati Alkis
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  3. Sengul Cangur
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  11. Abdurrahman Isikdogan
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  12. Ayse Demirci
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  13. Kaan Helvaci
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  14. Berna Oksuzoglu
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Correspondence to Ayse Durnali.

Additional information

This study was conducted on behalf of Anatolian Society of Medical Oncology (ASMO).

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Durnali, A., Alkis, N., Cangur, S. et al. Prognostic factors for teenage and adult patients with high-grade osteosarcoma: an analysis of 240 patients. Med Oncol 30, 624 (2013). https://doi.org/10.1007/s12032-013-0624-6

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  • DOI: https://doi.org/10.1007/s12032-013-0624-6

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