Lung and bone metastases patterns in osteosarcoma: Chemotherapy improves overall survival

Area of Science:

• Oncology
• Medical Statistics

Background:

• Osteosarcoma (OS) is a primary bone malignancy with a propensity for metastasis.
• Simultaneous lung and bone metastases (LM and BM) in OS are infrequently reported, necessitating further investigation into associated risk and prognostic factors.

Purpose of the Study:

• To identify risk factors associated with lung metastases (LM) and/or bone metastases (BM) in osteosarcoma patients.
• To determine prognostic factors influencing overall survival in osteosarcoma patients with LM and/or BM.
• To evaluate the impact of treatments on survival outcomes for osteosarcoma with LM and/or BM.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database (2010-2019) for patient data.
• Employed univariate and multivariate logistic regression to identify risk factors for LM and/or BM.
• Applied Cox regression and Kaplan-Meier (K-M) curves with log-rank tests to analyze prognostic factors and overall survival.

Main Results:

• Female sex, larger tumor size, specific OS subtypes (telangiectatic, central), N1 stage, other locations, presence of BM, radiotherapy, and chemotherapy were correlated with LM.
• Age (25-59 years), T1 stage, LM, liver metastases, radiotherapy, and surgery were correlated with BM.
• Chondroblastic and small cell OS types, T1 stage, N1 stage, other locations, liver metastases, radiotherapy, and surgery were correlated with LM and BM.
• Metastases, radiotherapy, and surgery at the primary site were associated with LM and/or BM.
• Chemotherapy at the primary site significantly improved survival for LM and/or BM.
• Survival rates were lower for patients with LM (61.47% mortality), BM (72.04% mortality), and LM and BM (69.49% mortality), with older age, absence of surgery, and lack of chemotherapy being detrimental.

Conclusions:

• Metastasis patterns in osteosarcoma are influenced by various clinical and pathological factors.
• Treatment modalities, particularly chemotherapy at the primary site, play a crucial role in improving survival outcomes for osteosarcoma patients with advanced disease.
• Age and absence of timely, appropriate treatment negatively impact survival in osteosarcoma with lung and/or bone metastases.