Clinical factors affecting prognosis of limb osteosarcoma in China: a multicenter retrospective analysis

J Int Med Res. 2020 Aug;48(8):300060520930856. doi: 10.1177/0300060520920053.

Abstract

Objective: This study was performed to explore the relationship between various clinical factors and the prognosis of limb osteosarcoma.

Methods: We retrospectively analyzed the clinical data of 336 patients with limb osteosarcoma treated from June 2000 to August 2016 at 7 Chinese cancer centers. Data on the patients' clinical condition, treatment method, complications, recurrences, metastasis, and prognosis were collected and analyzed. Kaplan-Meier analysis and Cox regression models were used to analyze the data.

Results: The patients comprised 204 males and 132 females ranging in age from 6 to 74 years (average, 21.1 years). The overall 3- and 5-year survival rates were 65.0% and 55.0%, respectively. The 5-year overall survival rate was 64.0% with standard chemotherapy and 45.6% with non-standard chemotherapy. Cox regression analysis demonstrated that standard chemotherapy, surgery, recurrence, and metastasis were independent factors associated with the prognosis of limb osteosarcoma.

Conclusion: The survival of patients with limb osteosarcoma can be significantly improved by combining standard chemotherapy and surgery. The overall survival rate can also be improved by adding methotrexate to doxorubicin-cisplatin-ifosfamide triple chemotherapy.

Keywords: Osteosarcoma; chemotherapy; metastasis; multicenter analysis; prognosis; recurrence.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Neoplasms* / diagnosis
  • Bone Neoplasms* / drug therapy
  • Child
  • China
  • Cisplatin / therapeutic use
  • Disease-Free Survival
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Ifosfamide / therapeutic use
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Osteosarcoma* / diagnosis
  • Osteosarcoma* / drug therapy
  • Prognosis
  • Retrospective Studies
  • Young Adult

Substances

  • Doxorubicin
  • Cisplatin
  • Ifosfamide
  • Methotrexate