title: [The effect of resistance-related proteins on the prognosis and survival of patients with osteosarcoma: an immunohistochemical analysis].
abstract: OBJECTIVE
  Despite the developments in chemotherapy protocols, improvement in the survival rates of osteosarcoma has been limited. We evaluated the effect of certain prognosis-related proteins on survival of patients with osteosarcoma.
  
  
  METHODS
  Data from 45 patients (24 males, 21 females) who were treated and followed-up for osteosarcoma were reviewed. Following neoadjuvant chemotherapy, 41 patients underwent extremity saving surgery, and four patients underwent amputation. The most frequent localization was the lower end of the femur (n=23, 51.1%), followed by the upper end of the tibia (n=10, 22.2%). Three patients had metastasis on admission. Surgical resection samples were retrieved from the pathology archive and analyzed immunohistochemically for the expression of p-glycoprotein p170, p53, heat-shock protein 27 (HSP27), HSP90, and nm23. The effect of these proteins on prognosis and survival was assessed with survival analysis using the Kaplan-Meier method. The mean follow-up was 49.7 months (range 6 to 185 months).
  
  
  RESULTS
  Three patients with metastasis on admission died within five years due to pulmonary metastasis. New metastases developed in 29 patients. Total 5-year and 10-year survival rates were 60% and 43%, respectively. The corresponding disease-free survival rates were 41% and 24%. Five-year survival was 29% in patients who developed metastasis. Among clinical factors, survival was influenced only by the presence of metastasis on admission (p=0.044). Five-year and 10-year survival rates were significantly different between patients with and without p53 positivity (p=0.04), while the other proteins were not significantly associated with survival.
  
  
  CONCLUSIONS
  Our data suggest that p53 may be used as a prognostic marker in osteosarcoma due to its significant association with survival.
authors.affiliation: Istanbul Universitesi Istanbul Tip Fakültesi, Ortopedi ve Travmatoloji Anabilim Dali, Istanbul, Turkey.
authors.forename: Harzem
authors.initials: H
authors.lastname: Ozger
authors.forename: Levent
authors.initials: L
authors.lastname: Eralp
authors.forename: Ata Can
authors.initials: AC
authors.lastname: Atalar
authors.forename: Berkin
authors.initials: B
authors.lastname: Toker
authors.forename: Lora
authors.initials: L
authors.lastname: Esberk Ateş
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sungur
authors.forename: Bilge
authors.initials: B
authors.lastname: Bilgiç
authors.forename: Inci
authors.initials: I
authors.lastname: Ayan
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D055551:HSP27 Heat-Shock Proteins / Q000378:metabolism; D018841:HSP90 Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D055815:Young Adult
chemical_list: D018435:ATP Binding Cassette Transporter, Subfamily B; D014408:Biomarkers, Tumor; D055551:HSP27 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; D016159:Tumor Suppressor Protein p53