TY - JOUR
T1 - Comparison of the outcome of conventional osteosarcoma at two specialist international orthopaedic oncology centres
AU - Ford, Samuel
AU - Saithna, Adnan
AU - Grimer, Robert J.
AU - Picci, Piero
PY - 2004/3
Y1 - 2004/3
N2 - Objective: To determine the prognostic value of patient and treatment parameters in osteosarcoma, and whether these are equally important across international boundaries. Design: Retrospective, cross-sectional study of 428 patients diagnosed with around-knee osteosarcoma, between 1990 and 1997 in Birmingham, UK, and Bologna, Italy. Disease-free survival (DFS) and overall survival (OS) assessed by Kaplan-Meier, Fisher's PLSD and Cox proportional hazard regression. Results: Five-year DFS and OS were 56 and 73% at Centre 1, compared to 43 and 60% at Centre 2 (P= 0.0022 and P=0.025, respectively). The most important bad prognostic factors for DFS and OS respectively were raised alkaline phosphatase at diagnosis (P=0.002 and P=0.003), tumour necrosis 150 cm 3 at diagnosis (P=0.04 and P=0.006). The most significant combination of bad prognostic factors was alkaline phosphatase and tumour necrosis. A total of 73% of patients at Centre 1 had greater than 90% necrosis of the tumour following neoadjuvant chemotherapy compared with 29% at Centre 2. Conclusions: Tumour-based prognostic factors have similar significance across international boundaries. Chemotherapy effectiveness appears to be a major factor in explaining the survival difference between the two centres.
AB - Objective: To determine the prognostic value of patient and treatment parameters in osteosarcoma, and whether these are equally important across international boundaries. Design: Retrospective, cross-sectional study of 428 patients diagnosed with around-knee osteosarcoma, between 1990 and 1997 in Birmingham, UK, and Bologna, Italy. Disease-free survival (DFS) and overall survival (OS) assessed by Kaplan-Meier, Fisher's PLSD and Cox proportional hazard regression. Results: Five-year DFS and OS were 56 and 73% at Centre 1, compared to 43 and 60% at Centre 2 (P= 0.0022 and P=0.025, respectively). The most important bad prognostic factors for DFS and OS respectively were raised alkaline phosphatase at diagnosis (P=0.002 and P=0.003), tumour necrosis 150 cm 3 at diagnosis (P=0.04 and P=0.006). The most significant combination of bad prognostic factors was alkaline phosphatase and tumour necrosis. A total of 73% of patients at Centre 1 had greater than 90% necrosis of the tumour following neoadjuvant chemotherapy compared with 29% at Centre 2. Conclusions: Tumour-based prognostic factors have similar significance across international boundaries. Chemotherapy effectiveness appears to be a major factor in explaining the survival difference between the two centres.
KW - Osteosarcoma
KW - Prognostic factors
KW - Survival
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U2 - 10.1080/13577140410001679202
DO - 10.1080/13577140410001679202
M3 - Article
C2 - 18521388
AN - SCOPUS:1842453756
VL - 8
SP - 13
EP - 18
JO - Sarcoma
JF - Sarcoma
SN - 1357-714X
IS - 1
ER -