Developing a prognostic model for patients with localized osteosarcoma treated with uniform chemotherapy protocol without high dose methotrexate: A single‐center experience of 237 patients. Issue 6 (18th September 2015)

• Record Type: Journal Article
• Authors: Nataraj, Vijayamurugan; Batra, Atul; Rastogi, Shishir; Khan, Shah Alam; Sharma, Mehar Chand; Vishnubhatla, Sreenivas; Bakhshi, Sameer
• Is Part Of: Journal of surgical oncology. Volume 112:Issue 6(2015:Nov. 01)
• Page Start: 662
• Page End: 668
• Publication Date: 2015-09-18
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24045
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso24045-sec-0001" sec-type="section"> <title>Background</title> <p>Studies of baseline prognostic factors in patients with localized osteosarcoma treated without high dose methotrexate are limited.</p> </sec> <sec id="jso24045-sec-0002" sec-type="section"> <title>Methods</title> <p>This is single‐institutional review of localized osteosarcoma patients treated without high dose methotrexate between June 2003–December 2012. A multivariate analysis of impact of baseline and treatment characteristics on outcome was performed and a prognostic model was developed based solely on baseline factors for predicting event‐free survival (EFS) and overall survival (OS).</p> </sec> <sec id="jso24045-sec-0003" sec-type="section"> <title>Results</title> <p>Of 237 patients with median age of 17 years (range 2–66 yrs), neoadjuvant chemotherapy (NACT) was administered in 220 (92.82%) patients. Post NACT, 200/237 (84.38%) patients underwent surgery. At 30 months median follow‐up, 5‐year EFS and OS were 36.60 ± 0.03%, and 50.33 ± 0.04%, respectively. In multivariate analysis, baseline factors including duration of symptom >4 months (<italic>P</italic> < 0.001) and good performance status (PS) (<italic>P</italic> < 0.001) predicted better EFS whereas good PS (<italic>P</italic> = 0.01) and normal serum alkaline phosphatase (SAP) (<italic>P</italic> = 0.03) predicted better OS. The 5‐year EFS without any risk factor (symptom duration <4 months, PS>1) was 58.7 ± 0.1%, with either one factor 31.5 ± 0.1% and with both factors 21.9 ± 0.1%. The 5‐year OS without any risk factor (PS>1, elevated SAP) was 66.9 ± 0.1%, with either one factor 57.9 ± 0.1% and with both factors 25.6 ± 0.1%</p> </sec> <sec id="jso24045-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This prognostic model assists in categorizing risk‐groups within localized osteosarcoma. <italic>J. Surg. Oncol. 2015;112:662–668</italic>. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>