Prognostic value of radiological response to chemotherapy in patients with osteosarcoma.
BACKGROUND
Chemotherapy is essential to improve the prognosis of the patients with osteosarcoma, and the response to chemotherapy is an important prognostic factor. In this study, the impact of various radiological examinations on overall survival (OS) and event-free survival (EFS) was evaluated.


METHODS
Eighty-two patients with high-grade osteosarcoma were included in this study, and we evaluated the following factors for prognostic significance: age (≥40 years), gender (male), tumor location (truncal site), metastatic disease, histological response to chemotherapy, radiological response to chemotherapy assessed using X-ray, angiography, CT, MRI, (201)Tl scintigraphy, and (99m)Tc-MIBI scintigraphy ((99m)Tc-MIBI), and combined radiological score (CRS).


RESULTS
Univariate analyses revealed that metastatic disease, histological response, (99m)Tc-MIBI, and CRS were significantly correlated with OS. Multivariate analyses showed that metastatic disease (OS: HR 35.9, P<0.001; EFS: HR 17.32, P<0.001) was an independent predictor of OS and EFS. Tumor location (HR 36.1, P = 0.003), histological response (HR 31.1, P = 0.036), and (99m)Tc-MIBI (HR 18.4, P = 0.038) were significant prognostic factors for OS. Moreover, CRS was a marginally significant predictor of OS and EFS.


CONCLUSIONS
The chemotherapeutic effects evaluated by (99m)Tc-MIBI and CRS could be considered as prognostic factors in osteosarcoma.
Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
Shinji
S
Miwa
Akihiko
A
Takeuchi
Toshiharu
T
Shirai
Junichi
J
Taki
Norio
N
Yamamoto
Hideji
H
Nishida
Katsuhiro
K
Hayashi
Yoshikazu
Y
Tanzawa
Hiroaki
H
Kimura
Kentaro
K
Igarashi
Akishi
A
Ooi
Hiroyuki
H
Tsuchiya
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
D017256:Technetium Tc 99m Sestamibi