title: C-erbB-2 expression and prognostic significance in osteosarcoma.
abstract: BACKGROUND
  C-erbB-2 is postulated as a prognostic biological marker for osteosarcoma (OST). We investigated c-erbB-2 expression status in osteosarcomas and its prognostic significance.
  
  
  METHODS
  Archival pre-treatment tumor biopsies of 79 cases were stained by immunohistochemical (IHC) methods with CB11 antibody for cell-membrane specific c-erbB-2 expression. Relation with different variables was examined and survival rates were calculated.
  
  
  RESULTS
  Median age was 13 years (7-17). Distant metastases were detected in 8 (10.1%) cases at initial diagnosis. 36/79 (45.6%) patients had positive c-erbB-2 staining by IHC. There was no significant difference between c-erbB-2 expression and presence of distant metastases at initial diagnosis or during follow-up, gender, age groups, tumor size, tumor sites, serum alkaline phosphatase, and lactate dehydrogenase levels. At a median follow-up of 67.4 months (9.2-246.1), 36 cases died, 20 were alive, and 23 abandoned treatment. For 58 cases without initial metastases who underwent definitive surgery, 5-year event-free (EFS) and overall survival (OS) rates were 50% and 62.1% in cases negative for c-erbB-2 expression, and 22.4% and 32.3% in cases positive for c-erbB-2 expression, respectively (EFS, P = 0.044; OS, P = 0.029). Five-year EFS and OS rates were significantly higher in cases with a tumor size <10 cm. Cox regression analyses revealed that only size persisted as a prognostic factor for EFS. C-erbB-2 expression status didn't appear as an independent prognostic factor.
  
  
  CONCLUSIONS
  Overexpression of c-erbB-2 in OST was not correlated with metastatic potential. No independent prognostic significance was detected. The results do not support directed therapies for c-erbB-2 in OST.
authors.affiliation: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey. yalcinb@hacettepe.edu.tr
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalçin
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gedikoğlu
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.forename: Canan
authors.initials: C
authors.lastname: Akyüz
authors.forename: Münevver
authors.initials: M
authors.lastname: Büyükpamukçu
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D015999:Multivariate Analysis; D012516:Osteosarcoma / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases