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Prognostic factors among 130 patients with osteosarcoma
L Pochanugool1, T Subhadharaphandou, M Dhanachai
1Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clinical Orthopaedics and Related Research
|January 7, 1998
Summary
This study identified key prognostic factors for high-grade osteosarcoma, revealing that low serum lactic acid dehydrogenase and specific treatments significantly improve patient outcomes. Multidisciplinary care is crucial for better survival rates in osteosarcoma patients.
Area of Science:
- Oncology
- Orthopedic Surgery
- Radiotherapy
Background:
- High-grade osteosarcoma presents a significant challenge in pediatric and young adult oncology.
- Effective prognostic factor identification is crucial for tailoring multidisciplinary treatment strategies.
Purpose of the Study:
- To identify significant prognostic factors in patients with high-grade osteosarcoma.
- To evaluate the impact of various treatment modalities on patient survival.
Main Methods:
- Prospective enrollment of 130 high-grade osteosarcoma patients.
- Multidisciplinary treatment including intraarterial chemotherapy, local irradiation, limb salvage surgery, and prophylactic whole lung irradiation.
- Multivariate analysis and log rank tests for prognostic factor evaluation.
Main Results:
- Minimal serum lactic acid dehydrogenase (<300 IU/L) was a significant positive prognostic factor.
- History of trauma, local irradiation, favorable histologic response, and prophylactic whole lung irradiation correlated with better prognosis.
- Age, tumor site, fracture, subtype, symptoms, alkaline phosphatase, and ESR were not significant prognostic factors.
Conclusions:
- Serum lactic acid dehydrogenase level is a key prognostic indicator in osteosarcoma.
- Specific treatment components like local irradiation and prophylactic lung irradiation improve outcomes.
- The 9-year survival rate for the entire cohort was 55%, highlighting the need for optimized treatment strategies.