time dependency of prognostic factors in patients with stage II osteosarcomas.
Although several clinicopathologic parameters may be related to metastasis-free survival in osteosarcoma, the importance of prognostic factors with time is largely unknown. Therefore, we asked whether the clinical characteristics of patients with osteosarcoma with metastasis after 2 years differed from those of patients with an earlier metastatic event. We retrospectively reviewed 420 patients with Stage IIB osteosarcoma treated with surgery and chemotherapy. The minimum followup was 3 months (mean, 71.4 months; range, 3-257 months). Among the 420 patients, 167 patients had a metastatic event. A large proportion (43%) of the 35 good responders showed metastasis after 2 years, whereas 24% of the 96 poor responders showed late metastasis. Histologic response and chondroblastic subtype showed time-related changes. Poor histologic response showed a gradual decline in prognostic value and lost its importance after 2 years. Most metastatic events occurred within 2 years after diagnosis; therefore, we recommend new predictive strategies and followup protocol for patients experiencing late relapse.
Kim
Min Suk
MS
Department of Pathology, Korea Cancer Center Hospital, 215-4 Gongneung-dong, Nowon-gu, Seoul 139-706, Korea.
Cho
Wan Hyeong
WH
Song
Won Seok
WS
Lee
Soo-Yong
SY
Jeon
Dae-Geun
DG
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005269:Femur / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D012189:Retrospective Studies; D013977:Tibia / Q000473:pathology / Q000601:surgery; D013997:Time Factors