Postrelapse Prognostic Factors in Nonmetastatic Osteosarcoma: A Single-institution Experience

Area of Science:

• Pediatric Oncology
• Skeletal Tumors
• Cancer Research

Background:

• Osteosarcoma is a rare but aggressive bone cancer primarily affecting children and adolescents.
• Recurrence after initial treatment significantly impacts prognosis.
• Identifying prognostic factors for postrelapse survival (PRS) is crucial for guiding treatment decisions.

Purpose of the Study:

• To identify prognostic factors influencing postrelapse survival (PRS) in pediatric and adolescent patients with initial localized high-grade osteosarcoma.
• To analyze variables associated with improved outcomes after disease recurrence.

Main Methods:

• Retrospective analysis of 31 patients (≤21 years) with nonmetastatic high-grade osteosarcoma who experienced recurrence.
• Kaplan-Meier and log-rank tests for PRS and postrelapse event-free survival (PREFS) analyses.
• Multivariate Cox regression to determine independent prognostic variables.

Main Results:

• Median age at diagnosis was 13.7 years; median time to first relapse was 16 months.
• Fourteen patients achieved a second complete response (CR2).
• Five-year PRS and PREFS were 26%. Achievement of CR2 and favorable initial histologic response were significant independent predictors of PRS.

Conclusions:

• Achieving a second complete response (CR2) is a significant positive prognostic factor for survival after osteosarcoma recurrence.
• Histologic response to initial preoperative treatment independently predicts better survival in recurrent osteosarcoma patients.