Survival analysis and prognostic model establishment of secondary osteosarcoma: a SEER-based study

Area of Science:

• Oncology
• Surgical Oncology
• Biostatistics

Background:

• Secondary osteosarcoma (SO) treatment relies heavily on surgical excision.
• The impact of patient willingness to undergo surgery on SO survival remains understudied.

Purpose of the Study:

• To investigate the association between surgical compliance and overall survival (OS) in secondary osteosarcoma patients.
• To identify risk factors for non-compliance and develop a predictive model for patient survival.

Main Methods:

• Analysis of SEER database (1975-2008) for 688 SO patients recommended for surgery.
• Utilized multivariable logistic regression and Cox regression to assess surgical compliance's prognostic value.
• Developed and validated a nomogram model for predicting OS using the concordance index (C-index).

Main Results:

• 9.2% of patients refused surgery; non-compliance linked to earlier diagnosis and chemotherapy refusal.
• Lower surgical compliance significantly correlated with reduced OS (HR=1.733, P=0.003).
• The nomogram model demonstrated high accuracy (C-index=0.748) for predicting 3- and 5-year OS.

Conclusions:

• Surgical compliance is an independent prognostic factor for secondary osteosarcoma survival.
• Patient willingness to undergo surgery is critical for improving outcomes in SO.