Prognostic Factors and Outcome in Childhood and Adolescent Osteosarcoma: Single Institution Experience / 임상소아혈액종양

ABSTRACT

BACKGROUND: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. The aim of this study was to evaluate survival and the prognostic factors in children and adolescent osteosarcoma.METHODS: Twenty-seven patients with osteosarcoma diagnosed at Chonnam National University Hwasun Hospital between Apr. 2004 and Feb. 2013 were retrospectively reviewed.RESULTS: Fourteen patients were males and the median age at diagnosis was 13.0 years. The most common tumor site was distal femur and 5 patients had metastasis at diagnosis. All patient but one who underwent definitive surgery at diagnosis received preoperative chemotherapy. The 5-year overall survival (OS) and event free survival (EFS) rate for all patients were 65.7+/-10.2% and 55.6+/-11.0%, respectively. Ten patients (37.0%) experienced relapse or progression of the disease. Among them, 3 patients are alive without any evidence of disease at the time of this writing. Seven among 8 dead patients died of relapse/progression of the disease. The 5-year EFS rate was significantly higher for patients with tumor volume <100 cm3 (n=14) at diagnosis than others (n=10) (70.7+/-14.6% vs. 37.5+/-16.1%, P=.031). Age, histologic type, metastasis at diagnosis and histologic response to preoperative chemotherapy did not have a significant effect on OS and EFS.CONCLUSION: Although chemotherapy has improved outcomes of osteosarcoma, relapse or progression is the most common cause of treatment failure. A higher tumor volume at diagnosis was identified as a poor prognostic factor. Future studies incorporating a larger number of patients are required to further delineate the prognostic factors in osteosearcoma.