Postrelapse Prognostic Factors in Nonmetastatic Osteosarcoma: A Single-institution Experience. Issue 3 (April 2016)

• Record Type: Journal Article
• Authors: Berlanga, Pablo; Cañete, Adela; Salom, Marta; Montalar, Joaquin; Guasp, Maria; Marco, Alfredo; Castel, Victoria
• Is Part Of: Journal of pediatric hematology/oncology. Volume 38:Issue 3(2016)
• Publication Date: 2016-04
• Subjects: osteosarcoma -- recurrence -- prognosis -- treatment outcome -- child -- adolescent; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000546
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Purpose: The purpose of this study was to analyze the prognostic factors that influence postrelapse survival (PRS) in children and adolescents with initial localized high-grade osteosarcoma. Methods/Patients: This is a retrospective evaluation of patients aged 21 years and below with nonmetastatic high-grade osteosarcoma treated at our institution from 1985 to 2011 who developed recurrent disease after achievement of an initial complete response (CR). PRS and postrelapse event-free survival (PREFS) analyses were performed using the Kaplan-Meier method and log-rank test. Multivariate Cox regression analysis was used to determine which variables were independently prognostic. Results: Thirty-one patients were included. Median age at primary diagnosis was 13.7 years (range, 1.9 to 21.0 y). Median time to first relapse was 16 months (range, 3 to 36 mo). Fourteen patients achieved a second CR (CR2) after surgery±chemotherapy treatment. The 5-year PRS and PREFS were both 26% (95% confidence interval, 14%-49%), with a median follow-up of 99 months (range, 27 to 271 mo). Multivariate analysis showed that achievement of CR2 ( P <0.001) and histologic response to first-line treatment ( P =0.02) were significantly associated with PRS, whereas time to first relapse did not retain univariate significance. Conclusions: Achievement of CR2 and histologic response to preoperative first-line treatment are independent survival prognostic factors in osteosarcoma recurrence.