Objective:The aim of this study was to assess the differences in clinical appearance and prognosis of osteosarcoma between preadolescent and adolescent in Chinese patients and investigate whether age at diagnosis is a...Objective:The aim of this study was to assess the differences in clinical appearance and prognosis of osteosarcoma between preadolescent and adolescent in Chinese patients and investigate whether age at diagnosis is a prognostic indicator.Methods:Between May 2002 and May 2009,ninety-six children with high-grade osteosarcoma treated at our institute were stratified according to the age of 10.There were 19 preadolescents(≤ 10 years) and 77 adolescents(10 years < age ≤ 19 years),and their medical records were reviewed and compared using Fisher exact tests.Overall survival and disease-free survival was estimated by Kaplan-Meier methods and compared using log-rank tests.The prognostic significance of the various factors on survival was examined by Cox regression analysis.Results:There were no significant differences in terms of Karnofsky Performance Status(KPS) score,Enneking stage,tumor location,histologic type,pathologic fracture,tumor necrosis rate,tumor size,relapse and frequencies of adjuvant chemotherapy between the two groups.A high proportion of preadolescent patients was treated with amputation(78.9% vs.44.2%;P = 0.01).The 5-year survival of the preadolescent and adolescent groups was(38 ± 14)% and(33 ± 10)%,and the 2-year disease free survival for each group was(45 ± 12)% and(44.4 ± 6.3)%,respectively.Our study showed that age did not have any statistical significance for survival(P = 0.803).Univariate analysis indicated that KPS score;frequencies of adjuvant chemotherapy,tumor size and relapse were significantly related to overall survival.Multivariate Cox regression analysis revealed that both frequencies of adjuvant chemotherapy and relapse were independently prognostic factors for survival.Conclusion:Clinical characteristics and survival between the preadolescents and adolescents with osteosarcoma in China were compatible.So we suggested that there did not need to treat preadolescents patients by alternative and/or aggressive therapies compared with adolescent patients.展开更多
Objective:The aim of this study was to identify prognostic factors and imply the appropriate management for local recurrent osteosarcoma.Methods:The clinical records of 60 patients with local recurrence osteosarcoma w...Objective:The aim of this study was to identify prognostic factors and imply the appropriate management for local recurrent osteosarcoma.Methods:The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010.The mean followed-up time for these patients was 49.1 months(range 13 to 143 months).The factors of age,gender,tumor site,tumor size,surgical procedure,neoadjuvant chemotherapy,frequency of primary postoperative adjuvant chemotherapy,lung metastasis,metastasis of other sites(except for lung) and treatment after local recurrence were selected as the measurements for this analysis.Kaplan-Meier method was used to measure the overall survival and post-recurrence survival.The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test.The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival.Results:The median post-recurrence survival and overall survival of 60 patients were 32 months(95% confidence interval:16.2-47.8) and 55 months(95% confidence interval:39.3-70.7) respectively.The 2and 3-year cumulative survival rates were 81.7% and 55.4%,respectively.The Log-rank univariate analysis showed that age,gender,tumor size,metastasis of other sites(except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence(P < 0.05).The Cox regression analysis revealed that gender(P = 0.016),metastasis of other sites(except for lung,P = 0.017) and treatment after local recurrence(P = 0.028) were the independent prognostic factors of osteosarcoma with local recurrence.On the other hand,the prognosis of local recurrent osteosarcoma was not associated with tumor site,surgical procedure,frequency of primary postoperative adjuvant chemotherapy,neoadjuvant chemotherapy and lung metastasis(P > 0.05).Conclusion:The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site(except for lung) and the treatment after local recurrence.The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.展开更多
基金Supported by grants from the National Natural Science Foundation of China (No. 81001191)Science and Technology Commission of Shanghai (No. 10PJ1408300)
文摘Objective:The aim of this study was to assess the differences in clinical appearance and prognosis of osteosarcoma between preadolescent and adolescent in Chinese patients and investigate whether age at diagnosis is a prognostic indicator.Methods:Between May 2002 and May 2009,ninety-six children with high-grade osteosarcoma treated at our institute were stratified according to the age of 10.There were 19 preadolescents(≤ 10 years) and 77 adolescents(10 years < age ≤ 19 years),and their medical records were reviewed and compared using Fisher exact tests.Overall survival and disease-free survival was estimated by Kaplan-Meier methods and compared using log-rank tests.The prognostic significance of the various factors on survival was examined by Cox regression analysis.Results:There were no significant differences in terms of Karnofsky Performance Status(KPS) score,Enneking stage,tumor location,histologic type,pathologic fracture,tumor necrosis rate,tumor size,relapse and frequencies of adjuvant chemotherapy between the two groups.A high proportion of preadolescent patients was treated with amputation(78.9% vs.44.2%;P = 0.01).The 5-year survival of the preadolescent and adolescent groups was(38 ± 14)% and(33 ± 10)%,and the 2-year disease free survival for each group was(45 ± 12)% and(44.4 ± 6.3)%,respectively.Our study showed that age did not have any statistical significance for survival(P = 0.803).Univariate analysis indicated that KPS score;frequencies of adjuvant chemotherapy,tumor size and relapse were significantly related to overall survival.Multivariate Cox regression analysis revealed that both frequencies of adjuvant chemotherapy and relapse were independently prognostic factors for survival.Conclusion:Clinical characteristics and survival between the preadolescents and adolescents with osteosarcoma in China were compatible.So we suggested that there did not need to treat preadolescents patients by alternative and/or aggressive therapies compared with adolescent patients.
文摘Objective:The aim of this study was to identify prognostic factors and imply the appropriate management for local recurrent osteosarcoma.Methods:The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010.The mean followed-up time for these patients was 49.1 months(range 13 to 143 months).The factors of age,gender,tumor site,tumor size,surgical procedure,neoadjuvant chemotherapy,frequency of primary postoperative adjuvant chemotherapy,lung metastasis,metastasis of other sites(except for lung) and treatment after local recurrence were selected as the measurements for this analysis.Kaplan-Meier method was used to measure the overall survival and post-recurrence survival.The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test.The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival.Results:The median post-recurrence survival and overall survival of 60 patients were 32 months(95% confidence interval:16.2-47.8) and 55 months(95% confidence interval:39.3-70.7) respectively.The 2and 3-year cumulative survival rates were 81.7% and 55.4%,respectively.The Log-rank univariate analysis showed that age,gender,tumor size,metastasis of other sites(except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence(P < 0.05).The Cox regression analysis revealed that gender(P = 0.016),metastasis of other sites(except for lung,P = 0.017) and treatment after local recurrence(P = 0.028) were the independent prognostic factors of osteosarcoma with local recurrence.On the other hand,the prognosis of local recurrent osteosarcoma was not associated with tumor site,surgical procedure,frequency of primary postoperative adjuvant chemotherapy,neoadjuvant chemotherapy and lung metastasis(P > 0.05).Conclusion:The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site(except for lung) and the treatment after local recurrence.The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.
