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KMID : 0387820140210020104
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Clinical Pediatric Hematology-Oncology
2014 Volume.21 No. 2 p.104 ~ p.113
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Prognostic Factors and Outcome in Childhood and Adolescent Osteosarcoma: Single Institution Experience
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Lee Mi-Ji
Choi Ha-Yeong
Jang Hae-In
Jung Sung-Taek
Chol Yoo-Duk
Heo Suk-Hee
Baek Hee-Jo
Kook Hoon
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Abstract
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Background: Osteosarcoma is the most common primary malignant bone tumor in chil-dren 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%) experi-enced 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.
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KEYWORD
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Osteosarcoma, Tumor volume, Prognostic factor
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