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Published on: October 28, 2021
Prognostic factors in localized extremity osteosarcoma: a systematic review
J A M Bramer1, J H van Linge, R J Grimer
1Department of Orthopedic Surgery (G4 221), Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. jbramer@wxs.nl
Summary
Identifying reliable prognostic factors for osteosarcoma is challenging. This review found chemotherapy response, tumor size, site, alkaline phosphatase, and p-glycoprotein expression as potential independent factors in osteosarcoma patients.
Area of Science:
- Oncology
- Medical Research
Background:
- Reliable prognostic factors for osteosarcoma are difficult to establish.
- Previous reviews identified chemotherapy response as a key factor.
Purpose of the Study:
- To identify evidence-based prognostic factors for osteosarcoma published since 1992.
- To establish pooled relative risks for identified prognostic factors.
Main Methods:
- Systematic literature search of MEDLINE and Embase (1992-2006).
- Independent selection and quality assessment of papers on localized extremity osteosarcoma.
- Attempted to pool results for prognostic factors.
Main Results:
- 93 papers were analyzed in depth from 1777 initial results.
- Chemotherapy response, tumor size, tumor site, alkaline phosphatase, and p-glycoprotein expression emerged as potential independent factors.
- Only 7 papers met quality standards for analysis; some new factors showed promise.
Conclusions:
- Despite abundant literature, few studies meet high-quality standards for definitive conclusions on osteosarcoma prognosis.
- Heterogeneity among studies hinders the pooling of results.
- Standardization of study design and reporting is crucial for future research.
