Prognosis of extremity osteosarcoma in patients aged 40-60 years: a cohort/case controlled study at a single institute.

Abstract

BACKGROUND:

The outcome of older osteosarcoma patients with multi-disciplinary management has not been clearly defined.

METHODS:

We conducted a cohort (n=375) and a case-control (n=78) study on 26 older age patients (40-60 years) with localized osteosarcoma of extremity. In the case-control study, controls were matched for location and initial tumor volume.

RESULTS:

Compared to 349 younger patients, older age patients showed an osteolytic pattern on plain radiographs (P=0.05), fibroblastic subtype (P<0.01), and poor histologic response (P=0.03). Multivariate analysis revealed that a large absolute tumor volume (P<0.01), a tumor location in the proximal humerus (P=0.02), and a poor histologic response to preoperative chemotherapy (P<0.01) independently predicted poorer metastasis-free survival. However, an older age showed marginal significance (P=0.09). A case-control study showed a higher proportion of the fibroblastic subtype and poor histologic response in the case group. Five-year metastasis-free survival rates for the 26 cases and 52 controls were 40.1+/-10.1% and 61.5+/-6.8%, respectively (P=0.02).

CONCLUSIONS:

Older age osteosarcoma patients showed an unfavorable histologic response to chemotherapy and lower survival than younger patients. Nevertheless, a further larger-scale study is required to confirm our observations.

• Authors: W S Song, C-B Kong, D-G Jeon, W H Cho, M S Kim, J A Lee, J Y Yoo, J D Kim, S-Y Lee
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 36 Issue 5 Pg. 483-8 (May 2010) ISSN: 1532-2157 [Electronic] England
• PMID: 20363585 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2010 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Age Factors
• Bone Neoplasms (drug therapy, pathology, surgery)
• Case-Control Studies
• Cohort Studies
• Combined Modality Therapy
• Extremities
• Female
• Humans
• Limb Salvage
• Male
• Middle Aged
• Osteosarcoma (drug therapy, pathology, surgery)
• Prognosis
• Retrospective Studies