An examination of the efficacy of the 8 cm maximal tumor diameter cutoff for the subdivision of AJCC stage II osteosarcoma patients

Kim, Min Suk; Lee, Soo-Yong; Cho, Wan Hyeong; Song, Won Seok; Koh, Jae-Soo; Lee, Jun Ah; Yoo, Ji Young; Shin, Duk Seop; Jeon, Dae‐Geun

doi:10.1002/jso.21125

Cited by 15 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, similar to other prior studies [1,3,4,11], proximal tumor site had significant negative prognostic implications in our cohort of patients with extremity long bone osteosarcoma. It is unknown why proximal tumors have poor prognosis compared to distal tumors.…”

Section: Discussionsupporting

confidence: 90%

Proximal location in extremity long bones is a poor prognostic factor for osteosarcoma: A retrospective cohort study of 153 patients

Cates

Schoenecker

2016

Acta Oncologica

View full text Add to dashboard Cite

Background: Osteosarcomas arising in the proximal femur, humerus, and tibia appear to have poorer outcomes than those arising in distal long bones. However, the strength of this association is uncertain, particularly in light of other prognostic factors. Therefore, this retrospective cohort study was performed to compare patient outcomes between proximal and distal tumor location within extremity long bones. Material and methods: A total of 153 patients with conventional high-grade osteosarcoma of the extremity long bones, pelvis, or axial skeleton who had undergone neoadjuvant chemotherapy and surgical resection between 1985 and 2010 were identified in the Surgical Pathology files at Vanderbilt Medical Center. Effect of anatomic location within a proximal long bone was assessed using multivariable Cox proportional hazard regression. Results: Proximal tumor location was a strong predictor of poor prognosis in univariate survival analysis. Multivariate regression analysis showed that after controlling for American Joint Committee on Cancer (AJCC) stage, histologic response to chemotherapy, surgical resection margin status, and histologic type, location in the proximal femur, tibia, and humerus were independent risk factors for death due to osteosarcoma, but not event-free survival. Conclusion: Osteosarcomas of the proximal extremity long bones are associated with decreased disease-specific survival compared to tumors of the distal long bones, even after accounting for other key prognostic covariates.

show abstract

Section: Discussionsupporting

confidence: 90%

Proximal location in extremity long bones is a poor prognostic factor for osteosarcoma: A retrospective cohort study of 153 patients

Cates

Schoenecker

2016

Acta Oncologica

View full text Add to dashboard Cite

show abstract

“…Although the effective cutoff range is still uncertain, tumor size has been reported as a definitive prognostic factor in osteosarcoma [20, 21]. Although the cutoff of 8 cm in maximal tumor diameter was not a prognostic factor for metastasis in our study, we integrated tumor size into our nomogram for clinical considerations.…”

Section: Discussionmentioning

confidence: 99%

Postoperative nomogram to predict the probability of metastasis in Enneking stage IIB extremity osteosarcoma

et al. 2014

View full text Add to dashboard Cite

BackgroundMetastasis is the most crucial prognostic factor in osteosarcoma. The goal of this study was to develop a new nomogram to predict the probability of metastasis in Enneking stage IIB extremity osteosarcoma after neoadjuvant chemotherapy and limb salvage surgery.MethodsWe examined medical records of 91 patients who had undergone surgery between March 1994 and March 2007. A nomogram was developed using multivariate logistic regression. The nomogram was validated internally by bootstrapping-method (200 repetitions) and externally in independent validation set (n = 34). A Youden-derived cutoff value was assigned to the nomogram to predict dichotomous outcomes for metastasis.ResultsThe nomogram was built from four predictors of tumor site, serum alkaline phosphatase, intracapsular extension, and Huvos grade, and an additional clause that the cutoff value should be added to the total points in the cases of incomplete surgical resection. P-value of Hosmer and Lemshow Goodness-of-fit test of this model was 0.649. Area under receiver operating curve values of 0.83 (95% confidence interval [CI], 0.75 to 0.92) in the training set and 0.80 (95% CI, 0.63 to 0.96) in the validation set were obtained. The accuracy of dichotomous outcomes was 79.1% (95% CI, 0.69 to 0.86) and 82.4% (95% CI, 0.63 to 0.92) in the training and validation sets.ConclusionsWe have developed a new high-performance nomogram to predict the probability of metastasis in Enneking stage IIB extremity osteosarcoma after limb salvage surgery.

show abstract

“…First, small tumor volume. It has been reported that for osteosarcoma, less tumor size and reduction or stabilization in tumor volume represented good response to chemotherapy and thus better clinical outcome 9, 10, 24, 25. Secondly, three‐dimensional MRI imaging to accurately define that the tumor margin is suitable for hemicortical resection.…”

Section: Discussionmentioning

confidence: 99%

High‐grade osteosarcoma treated with hemicortical resection and biological reconstruction

Chen

et al. 2011

Journal of Surgical Oncology

View full text Add to dashboard Cite

Hemicortical resection for high-grade osteosarcomas located eccentrically in the long bones may be a reliable technique leading to good joint function by preserving surrounding healthy tissues. The functional outcome was encouraging, although long-term follow-up is mandatory to validate. With the advancement of chemotherapy and radiographic three-dimensional imaging, the safe margin in wide excision of high-grade osteosarcoma may be narrowed down in light of joint surface preservation.

show abstract

An examination of the efficacy of the 8 cm maximal tumor diameter cutoff for the subdivision of AJCC stage II osteosarcoma patients

Cited by 15 publications

References 19 publications

Proximal location in extremity long bones is a poor prognostic factor for osteosarcoma: A retrospective cohort study of 153 patients

Proximal location in extremity long bones is a poor prognostic factor for osteosarcoma: A retrospective cohort study of 153 patients

Postoperative nomogram to predict the probability of metastasis in Enneking stage IIB extremity osteosarcoma

High‐grade osteosarcoma treated with hemicortical resection and biological reconstruction

Contact Info

Product

Resources

About