Clinical features in osteosarcoma and prognostic implications

INTRODUCTION:Identification of variables that determine the prognosis for osteosarcoma may enable stratification of patients into subgroups with better or worse risk of local recurrence, metastases and death due to the disease. Discovery of such prognostic factors would permit selection of a subgroup of at-risk patients, with the aim of improving the therapeutic effectiveness.OBJECTIVE:To identify prognostic factors related to local recurrence-free survival, metastasis-free survival and overall survival among patients with highly malignant primary osteosarcoma that was non-metastatic on diagnosis and had poor response to neoadjuvant chemotherapy.SAMPLE AND METHODS:Out of 45 patients admitted to a referral center in Brazil between 2000 and 2004, 24 were selected for this study.RESULTS:The adverse factors that influenced the risk of local recurrence and the overall survival in univariate analysis were histological subtype other than osteoblastic (p = 0.017) and tumor size greater than 15 cm (p = 0.048). In relation to metastasis-free survival, the non-osteoblastic subtype had a worse prognosis (p = 0.007). The association of histological subtype maintained its significance in multivariate analysis for all studied survival categories.CONCLUSIONS:Tumor size greater than 15 cm is an adverse factor for local recurrence-free survival and overall survival but did not influence metastasis-free survival. The osteosarcoma histological type is a significant independent predictor for local recurrence-free survival, metastasis-free survival and overall survival.

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“…In the majority of studies,2,10,11,13,14 the osteoblastic variant was the most common histological type. The present study found the same result.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in the Survival of Patients Diagnosed with Primary Non-Metastatic Osteosarcoma with a Poor Response to Neoadjuvant Chemotherapy

Júnior

Camargo

2009

Clinics

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“…It is well documented that tumor size and tumor stage, as well as response to neoadjuvant chemotherapy, are important clinical characteristics in OS [ 24 ]. Several groups have reported that B7-H4 overexpression was frequently associated with many clinicopathological features, including tumor size, lymph node metastasis, depth of tumor invasion, and TNM stage [ 12 , 14 , 16 ], which also further gives prominence to the importance of B7-H4 in the development and progression of many tumors.…”

Section: Discussionmentioning

confidence: 99%

B7-H4 Expression Is Associated with Tumor Progression and Prognosis in Patients with Osteosarcoma

Dong

2015

BioMed Research International

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Increasing evidences have demonstrated that B7-H4 is associated with tumor development and prognosis. However, the clinical significance of B7-H4 expression in human osteosarcoma (OS) remains unclear. The aim of present study was to examine the B7-H4 expression and to explore its contribution in OS. B7-H4 expression in OS tissues was examined by immunohistochemistry. Soluble B7-H4 (sB7-H4) levels in blood were examined by ELISA. The association of B7-H4 expression with clinicopathological factors or prognosis was statistically analyzed. Our findings demonstrated that B7-H4 expression in OS tissues was significantly higher than those in paired normal bone tissues (P < 0.001). sB7-H4 level in OS serum samples was significantly higher than that in healthy controls (P = 0.005). High B7-H4 expression in tissues and sB7-H4 level were both correlated with advanced tumor stage (P < 0.001, P = 0.017, resp.) and distant metastasis (P = 0.034, P = 0.021, resp.). Additionally, high B7-H4 expression or serum sB7-H4 levels were significantly related to poor overall survival (P = 0.028, P = 0.005, resp.). B7-H4 in tissues and serum samples were an independent factor for affecting the survival time of OS patients (P = 0.004, P = 0.041, resp.). Collectively, our data suggest that the evaluation of B7-H4 expression in tissues and blood is a useful tool for predicting the progression of osteosarcoma and prognosis.

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“…[ 9 10 ] The factors for unfavorable prognosis include the presence of metastatic disease at diagnosis, tumor resection with compromised margins, absence of response to chemotherapy, voluminous tumors and elevated serum levels of lactate dehydrogenase (LDH). [ 11 ] The treatment of choice in oral osteosarcomas is surgical resection. Obtaining tumor free surgical margin is one of the main factors for local control.…”

Section: Introductionmentioning

confidence: 99%

Chondroblastic osteosarcoma

Medrado

Almeida

Mascarenhas

et al. 2014

J Oral Maxillofac Pathol

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The purpose of this paper is to report a case of chondroblastic osteosarcoma in the region of the maxilla, with 5 months of evolution. The term osteosarcoma refers to a heterogeneous group of malignancies with bone formation or mesenchymal tissue with histopathological evidence of osteogenic differentiation. The pattern of chondroblastic osteosarcoma represents 25% of all reported cases of this neoplasm. Its histopathological diagnosis is based on the predominance of a chondroid matrix formed in the midst of neoplastic cells. A woman patient, 27-year old, melanoderm, presented on extraoral exam with facial asymmetry caused by the a swelling in the premaxillary region with upper lip protrusion. Intraoral exam showed a maxillary tumefaction with involvement of the vestibular and palatine regions. The computerized tomography (CT) analysis exhibited a radiolucent mass with dispersed areas of radiopacity, with poorly defined and indistinct peripheral edges. The patient was subjected to incisional biopsy and histopathological examination showed the presence of a malignant neoplasm of mesenchymal origin characterized by the presence of irregular bone trabeculae dispersed among mildly atypical chondroblastic cells. The World Health Organization (WHO) recognizes several variants that differ in location, clinical behavior and degree of cellular atypia. The conventional or classical osteosarcoma is the most frequent variant, which develops within the medullary bone. This report illustrates the rapid evolution of one of the histological variants of osteosarcoma.

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Clinical features in osteosarcoma and prognostic implications

Cited by 19 publications

References 1 publication

Prognostic Factors in the Survival of Patients Diagnosed with Primary Non-Metastatic Osteosarcoma with a Poor Response to Neoadjuvant Chemotherapy

Prognostic Factors in the Survival of Patients Diagnosed with Primary Non-Metastatic Osteosarcoma with a Poor Response to Neoadjuvant Chemotherapy

B7-H4 Expression Is Associated with Tumor Progression and Prognosis in Patients with Osteosarcoma

Chondroblastic osteosarcoma

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