Analysis of Prognostic Factors in Osteosarcoma Adult Patients, a Single Institution Experience

Česká verzia

Authors: D. Adámková Krákorová ^1,2; K. Veselý ^2,3; I. Zambo ^2,3; Š. Tuček ^1,2; J. Tomášek ^1,2; A. Jurečková ^1,2; P. Janíček ^2,4; J. Černý ^2,4; L. Pazourek ^2,4; Š. Ondrůšek ^2,4; I. Selingerová ⁵
Authors place of work: Klinika komplexní onkologické péče, MOÚ Brno ¹; Lékařská fakulta, MU Brno ²; I. patologicko-anatomický ústav, FN u sv. Anny v Brně ³; I. ortopedická klinika, FN u sv. Anny v Brně ⁴; Ústav matematiky a statistiky, PřF MU Brno ⁵
Published in the journal: Klin Onkol 2012; 25(5): 346-358
Category: Original Articles

Summary

Background:
The objective of this report was to estimate long-term outcome and prognostic factors in adult patients with high-grade osteosarcoma. The intended therapeutic strategy included preoperative and/or postoperative chemotherapy as well as surgery of all operable lesions.

Patients and Metods:
We reviewed the clinical data of 36 newly diagnosed adult patients (aged 19–82, average 37.5, median 28.5 years) with high-grade osteosarcoma of the trunk or limbs evaluted by a multidisciplinary team and treated between 1999 and 2010 in Brno. Forty-five percent of patients were over thirty, more than 36% over forty. Thirty-one percent of patients had metastasis at the time of diagnosis. Demographic parameters, tumor-related and treatment-related variables included possible prognostic factors and their impact on response, overall survival (OS) and event-free survival (EFS) were analyzed.

Results:
All the patients were followed up after treatment. Seventy-three percent of patients were poor responders to chemotherapy. Sixteen patients are alive, and twenty patients died. The survival time ranged from 2 to 177 months (average 45 months, median survival 23 months). The 5-year OS of all patients was 52.4%. OS of patients without metastasis was 68.12%, while 2-year OS with metastasis was 26% only. 5-year EFS was 38.7%. Univariate analysis revealed that the prognosis of adult osteosarcoma patients was significantly related to distant metastasis (p = 0.006), surgical stage (p = 0.00582), serum alkaline phosphatase (ALP) level (p = 0.00841) and serum lactatdehydrogenase (LD) level (p = 0.047). The other analyzed prognostic factors including age had no statistically significant influence on outcome of osteosarcoma in adult patients.

Conclusion:
The prognosis of osteosarcoma in adult patients was significantly correlated to surgical stage, distant metastasis, serum ALP and LD.

Key words:
osteosarcoma – adult – prognostic factors – therapy

Submitted:
20. 6. 2012

Accepted:
7. 8. 2012

Zdroje

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