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07.01.2016 | Research Article | Ausgabe 9/2016

Clinical and Translational Oncology 9/2016

Prognosticating metastatic osteosarcoma treated with uniform chemotherapy protocol without high dose methotrexate and delayed metastasectomy: a single center experience of 102 patients

Zeitschrift:
Clinical and Translational Oncology > Ausgabe 9/2016
Autoren:
V. Nataraj, S. Rastogi, S. A. Khan, M. C. Sharma, S. Agarwala, S. Vishnubhatla, S. Bakhshi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s12094-015-1467-8) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Data on prognostic factors in patients with metastatic osteosarcoma treated with uniform chemotherapy protocol are lacking. The objective of this study was to analyze demographic data, treatment outcome and prognostic factors for patients with metastatic osteosarcoma at our center treated with a uniform chemotherapy protocol without high dose methotrexate.

Methods

This is a single-institutional data review of patients treated between June 2003 and December 2012 with neoadjuvant chemotherapy, local site surgery followed by adjuvant chemotherapy and metastasectomy at completion of adjuvant chemotherapy.

Results

102 patients of metastatic osteosarcoma were treated with a median age of 18 years (range 8–48 years), male to female ratio of 3.3:1 and median symptom duration of 4 months. EFS and OS at 5 years were 12.7 ± 0.1 and 28.1 ± 0.1 %, respectively. On multivariate analysis, elevated serum alkaline phosphatase (p < 0.001) and number of metastasis >3 (p = 0.04) were predictive of lower EFS, whereas elevated serum alkaline phosphatase (p = 0.01), number of metastasis >3 (p = 0.05), and margin positivity (p < 0.001) were predictive of lower OS.

Conclusions

This is the largest data on metastatic osteosarcoma treated with a uniform chemotherapy protocol without high dose methotrexate. The data showed prognostic factors similar to what have been observed previously such as elevated serum alkaline phosphatase and >3 metastatic lesions in lung predicting inferior outcome. Notably our survival was comparable to data from other studies despite our practice of delaying metastasectomy to completion of chemotherapy rather than performing the same along with local site surgery.

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Zusatzmaterial
Flow diagram depicting treatment schema (TIFF 98 kb)
12094_2015_1467_MOESM1_ESM.tif
Supplementary material 2 (DOCX 75 kb)
12094_2015_1467_MOESM2_ESM.doc
Literatur
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