Multiple Indeterminate pulmonary nodules (IPNs) as independent prognostic indicators in pediatric osteosarcoma: A ten-year retrospective study
- Yao Weitao 1, Du Xinhui 1, Li Zhehuang 1, Hou Jingyu 1, Ma Shengbiao 1, Zhang Panhong 1, Niu Xiaohui 2
- Yao Weitao 1, Du Xinhui 1, Li Zhehuang 1
- 1Bone and Soft Department, the Affiliated Cancer Hospital of Zheng Zhou University, He Nan Cancer Hospital, China.
- 2Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Peking University, China.
- 0Bone and Soft Department, the Affiliated Cancer Hospital of Zheng Zhou University, He Nan Cancer Hospital, China.
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View abstract on PubMed
Summary
This summary is machine-generated.Indeterminate Pulmonary Nodules (IPNs) are common in pediatric osteosarcoma. Multiple IPNs indicate a higher tumor burden and increased risk of metastasis, serving as a poor prognostic indicator for survival.
Area Of Science
- Oncology
- Radiology
- Pediatric Medicine
Background
- Osteosarcoma is the most common primary bone cancer in children and adolescents.
- Pulmonary metastasis significantly impacts osteosarcoma prognosis.
- The role of Indeterminate Pulmonary Nodules (IPNs) in risk stratification for pediatric osteosarcoma is not well-defined.
Purpose Of The Study
- To evaluate the incidence, progression, and prognostic significance of IPNs in pediatric and adolescent osteosarcoma patients.
- To provide insights for improved clinical staging and treatment strategies.
- To assess the association between IPNs and tumor burden or metastatic potential.
Main Methods
- Retrospective analysis of 126 osteosarcoma patients (≤20 years) treated between 2012-2022.
- Categorization into no IPN, solitary IPN, and multiple IPNs based on pre-treatment CT scans.
- Univariate, multivariate, and Cox regression analyses for risk factors and survival outcomes (MFS, OS).
Main Results
- Overall IPN incidence was 20.6%; multiple IPNs comprised 38.5% of IPN-positive cases.
- IPN-positive patients showed significantly higher bone involvement (>1/3 affected bone).
- Multiple IPNs were independently associated with a 2.87-fold increased risk of death (HR=2.87, p=0.020) and reduced 5-year OS (30.0% vs 69.0%, p=0.045).
Conclusions
- Indeterminate Pulmonary Nodules are relatively common in pediatric osteosarcoma.
- Multiple IPNs are a significant indicator of poor prognosis, linked to higher tumor burden and metastatic potential.
- Preoperative assessment of IPNs is crucial for risk stratification and personalized treatment strategies in osteosarcoma.
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