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) - Nataraj, Vijayamurugan
Abstract Background Studies of baseline prognostic factors in patients with localized osteosarcoma treated without high dose methotrexate are limited. Methods 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). Results 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 (P < 0.001) and good performance status (PS) (P < 0.001) predicted better EFS whereas good PS (P = 0.01) and normal serum alkaline phosphatase (SAP) (P = 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% Conclusions This prognostic model assists in categorizing risk‐groups within localized osteosarcoma. J. Surg. Oncol. 2015;112:662–668. © 2015 Wiley Periodicals, Inc.