Lung metastases at the initial diagnosis of high-grade osteosarcoma: prevalence, risk factors and prognostic factors. A large population-based cohort study
São Paulo med. j
;
137(5): 423-429, Sept.-Oct. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1059103
ABSTRACT
ABSTRACT BACKGROUND:
Osteosarcoma is the most prevalent malignant bone tumor in children and adolescents. Lung metastases are associated with poor prognosis.OBJECTIVE:
The aim here was to explore the prevalence of and risk and prognostic factors for lung metastases in high-grade osteosarcoma patients. DESIGN ANDSETTING:
Retrospective cohort study based on the Surveillance, Epidemiology and End Results (SEER) database in the United States.METHODS:
Data on 1,408 high-grade osteosarcoma patients registered in the SEER database between 2010 and 2015 were extracted. From these, all patients with high-grade osteosarcoma and initial lung metastasis were selected for analysis on risk and prognostic factors for lung metastases. Overall survival was estimated.RESULTS:
There were 238 patients (16.90%) with lung metastases at diagnosis. Axial location, tumor size > 10 cm (odds ratio, OR 3.19; 95% confidence interval, CI 1.58-6.45), higher N stage (OR 4.84; 95% CI 1.94-12.13) and presence of bone metastases (OR 8.73; 95% CI 4.37-17.48) or brain metastases (OR 25.63; 95% CI 1.55-422.86) were significantly associated with lung metastases. Younger age and surgical treatment (hazard ratio, HR 0.46; 95% CI 0.30-0.71) favored survival. Median survival was prolonged through primary tumor surgery.CONCLUSIONS:
The factors revealed here may guide lung metastasis screening and prophylactic treatment for osteosarcoma patients. A primary tumor in an axial location, greater primary tumor size, higher lymph node stage and presence of bone or brain metastases were significantly correlated with lung metastases. The elderly group (≥ 60 years) showed significant correlation with poor overall survival. For improved survival among high-grade osteosarcoma patients with lung metastases, aggressive surgery on the primary tumor site should be encouraged.
Full text:
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Index:
LILACS (Americas)
Main subject:
Osteosarcoma
/
Lung Neoplasms
Type of study:
Diagnostic study
/
Etiology study
/
Incidence study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2019
Type:
Article
Affiliation country:
China
Institution/Affiliation country:
Army Medical University/CN
/
Tianjin Institute of Medical and Pharmaceutical Sciences/CN
/
Tianjin's Clinical Research Center for Cancer/CN
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