Extremity osteosarcoma in childhood: prognostic value of radiologic imaging.
OBJECTIVE
To evaluate previously described radiologic prognostic factors in extremity osteosarcoma.


METHODS
In 47 pediatric patients, available images were evaluated for seven prognostic factors at diagnosis and seven additional factors after preoperative chemotherapy. These factors were correlated with histopathologic response and clinical outcome. The association of histopathologic response and outcome was also evaluated.


RESULTS
Metastases at presentation and a > 20-cm-diameter soft-tissue mass were predictive of a poor outcome but occurred in few patients. Factors most predictive of < 90% tumor necrosis after chemotherapy included an increase or no change in soft-tissue mass size and increased bone destruction. Although a significant relationship (P < .05) was found between histopathologic response and outcome, no factors predictive of histopathologic response were also predictive of outcome. The accuracy of pathologic response in predicting outcome was 66%.


CONCLUSIONS
Radiologic studies are of only limited use in predicting which patients with extremity osteosarcoma will have a poor response to chemotherapy or a poor outcome, and are not useful in predicting a good response or outcome.
Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
J A
JA
Lawrence
P S
PS
Babyn
H S
HS
Chan
P S
PS
Thorner
G E
GE
Pron
I J
IJ
Krajbich
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D005266:Femoral Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D016879:Salvage Therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013669:Technetium Tc 99m Medronate; D013977:Tibia / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D013669:Technetium Tc 99m Medronate