title: Prognostic factors in non-metastatic limb osteosarcoma: A 20-year experience of one center.
abstract: The purpose of this study was to evaluate the prognostic significance of variables in osteosarcoma. We performed a retrospective analysis of 35 patients with non-metastatic limb osteosarcoma that were treated between 1973 and 1994. The following variables were evaluated: age, sex, ethnic group, tumor histology and primary site, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels at diagnosis, treatment regimen, and the histologic response to treatment. Three variables showed significant correlation with prognosis: i) histologic response to preoperative treatment. Disease-free survival (DFS) was 89% in patients with grade III-IV histologic response after a median follow-up (MFU) of 64 months, 67% in patients with grade II after an MFU of 64 months, the patients with grade I response died within 15 months (p<0.0001); ii) treatment regimen. DFS was 83% after an MFU of 42 months, 62% after an MFU of 82 months, and 30% after an MFU of 177 months in patients treated by the 90's, 80's, and 70's protocols, respectively (p<0.05); iii) corrected ALP (cALP) levels at diagnosis. DFS was 78% after an MFU of 88 months in patients with cALP levels <200, and 32% after an MFU of 56 months in patients with cALP levels >200 (p=0.01). Low ALP levels, good histologic response to preoperative chemotherapy, and the new therapeutic regimen correlated with good prognosis in patients with osteosarcoma.
authors.affiliation: Department of Pediatric Gastroenterology, Mount Sinai Medical Center, New York, NY 10029, USA.
authors.forename: G
authors.initials: G
authors.lastname: Tomer
authors.forename: I J
authors.initials: IJ
authors.lastname: Cohen
authors.forename: D
authors.initials: D
authors.lastname: Kidron
authors.forename: K
authors.initials: K
authors.lastname: Katz
authors.forename: Z
authors.initials: Z
authors.lastname: Yosipovitch
authors.forename: I
authors.initials: I
authors.lastname: Meller
authors.forename: R
authors.initials: R
authors.lastname: Zaizov
mesh_terms: D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D000671:Amputation, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005121:Extremities; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D002955:Leucovorin / Q000008:administration & dosage; D015993:Life Tables; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000097:blood; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D014750:Vincristine; D004317:Doxorubicin; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; D002945:Cisplatin; D002955:Leucovorin; D008727:Methotrexate