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KMID : 1103720140710020058
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Journal of the Korean Society of Radiology
2014 Volume.71 No. 2 p.58 ~ p.64
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Prognostic Factors for Improved Survival after Pulmonary Metastasectomy from Osteosarcoma
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Choi Hyo-Sun
Park Jong-Heon
Choe Du-Hwan
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Abstract
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Purpose: The aim of this study was to evaluate the clinical characteristics and chest computed tomography (CT) images of the patients who underwent pulmonary metastasectomy from osteosarcoma, and to identify the prognostic factors associated with the improvement of survival.
Materials and Methods: Fifty-nine patients with pulmonary metastases from osteosarcoma were included. The prognoses of the patients were assessed by 5-year survival rate, after the pulmonary metastasectomy. The prognostic factors analyzed are as follows: age, sex, location of the primary osteosarcoma, disease-free interval (DFI) from the date of primary surgery to the date of pulmonary metastases on CT, number of pulmonary metastases, maximum diameter of largest pulmonary metastatic nodule, laterality (unilateral/bilateral), and location of pulmonary metastatic nodule(s). The log-rank test was used for univariate analyses, and the Cox proportional hazards model was used for multivariate analyses.
Results: The 5-year survival rate was 33.89%. Multivariate analyses revealed that a DFI > 12 months [p = 0.041, hazard ratio = 0.504, 95% confidence interval (CI) = 0.254-1.001] and nodule unilaterality (p = 0.029, hazard ratio = 0.291, 95% CI = 0.096-0.883) were the independent prognostic factors affecting the 5-year survival. The 5-year survival rates of patients with a DFI > 12 months and unilaterality of the metastatic nodule(s) increased to 44.11% and 39.28%, respectively.
Conclusion: The prognostic factors associated with the improved survival after pulmonary metastasectomy from osteosarcoma were the DFI > 12 months and the unilaterality of the metastatic nodules.
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KEYWORD
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Osteosarcoma, Metastasectomy, Prognosis, Lung
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