Prognostic factors and outcomes for osteosarcoma: an international collaboration.
We aimed to evaluate the prognostic significance of traditional clinical predictors in osteosarcoma through an international collaboration of 10 teams of investigators (2680 patients) who participated. In multivariate models the mortality risk increased with older age, presence of metastatic disease at diagnosis, development of local recurrence when the patient was first seen, use of amputation instead of limb salvage/wide resection, employment of unusual treatments, use of chemotherapeutic regimens other than anthracycline and platinum and use of methotrexate. It was also influenced by the site of the tumour. The risk of metastasis increased when metastatic disease was present at the time the patient was first seen and also increased with use of amputation or unusual treatment combinations or chemotherapy regimens not including anthracycline and platinum. Local recurrence risk was higher in older patients, in those who had local recurrence when first seen and when no anthracycline and platinum were used in chemotherapy. Results were similar when limited to patients seen after 1990 and treated with surgery plus combination chemotherapy. This large-scale international collaboration identifies strong predictors of major clinical outcomes in osteosarcoma.
Pakos
Emilios E
EE
Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece.
Nearchou
Andreas D
AD
Grimer
Robert J
RJ
Koumoullis
Haris D
HD
Abudu
Adesegun
A
Bramer
Jos A M
JA
Jeys
Lee M
LM
Franchi
Alessandro
A
Scoccianti
Guido
G
Campanacci
Domenico
D
Capanna
Rodolfo
R
Aparicio
Jorge
J
Tabone
Marie-Dominique
MD
Holzer
Gerold
G
Abdolvahab
Fashid
F
Funovics
Philipp
P
Dominkus
Martin
M
Ilhan
Inci
I
Berrak
Su G
SG
Patino-Garcia
Ana
A
Sierrasesumaga
Luis
L
San-Julian
Mikel
M
Garraus
Moira
M
Petrilli
Antonio Sergio
AS
Filho
Reynaldo Jesus Garcia
RJ
Macedo
Carla Renata Pacheco Donato
CR
Alves
Maria Teresa de Seixas
MT
Seiwerth
Sven
S
Nagarajan
Rajaram
R
Cripe
Timothy P
TP
Ioannidis
John P A
JP
D000293:Adolescent; D000671:Amputation, Surgical / Q000401:mortality*; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007391:International Cooperation; D023821:Limb Salvage / Q000401:mortality*; D008297:Male; D012516:Osteosarcoma / Q000401:mortality / Q000556:secondary / Q000628:therapy; D011379:Prognosis; D055815:Young Adult