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Survival and prognostic factors at time of diagnosis in high-grade appendicular osteosarcoma

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Authors:
  • Colding-Rasmussen, Thomas ;
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    Orthopaedics Surgery, Department of, Center of Head and Orthopaedic Surgery, Rigshospitalet, The Capital Region of Denmark
  • Thorn, Andrea Pohly ;
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    Orthopaedics Surgery, Department of, Center of Head and Orthopaedic Surgery, Rigshospitalet, The Capital Region of Denmark
  • Horstmann, Peter ;
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    Orthopaedics Surgery, Department of, Center of Head and Orthopaedic Surgery, Rigshospitalet, The Capital Region of Denmark
  • Rechnitzer, Catherine ;
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    Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
  • Hjalgrim, Lisa Lyngsie ;
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    Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet, The Capital Region of Denmark
  • Krarup-Hansen, Anders ;
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    Oncology, Department of, Herlev and Gentofte Hospital, The Capital Region of Denmark
  • Petersen, Michael Mørk
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    Orthopaedics Surgery, Department of, Center of Head and Orthopaedic Surgery, Rigshospitalet, The Capital Region of Denmark
Subtitle:
a 21 year single institution evaluation from east Denmark
DOI:
10.1080/0284186X.2017.1351620
Abstract:
BACKGROUND: Survival of patients with high-grade osteosarcoma (HOS), the most common primary bone cancer, has not improved significantly the last 30 years and the disease remains a major challenge. The purpose of this study is to evaluate survival in relation to prognostic factors at time of diagnosis among patients diagnosed with primary appendicular HOS in East Denmark between 1990 and 2010. MATERIAL AND METHODS: 101 patients (median age = 20 years, female/male ratio = 56/45) diagnosed with primary appendicular high-grade osteosarcoma between 1990 and 2010 were included in this study. Initially, 156 patients diagnosed with osteosarcoma between 1990 and 2010 were identified through the population based Regional Database of Pathology, which covers a population of approximately 2.7 million (east Denmark). 55 patients were excluded due to (A) tumor was low grade (n = 22), (B) located in axial skeleton (n = 18), (C) incorrect diagnosis (n = 11) or (D) biopsy represented a tumor relapse from a former primary osteosarcoma (n = 4). Overall survival was evaluated using the Kaplan-Meier survival analysis and log-rank test. Prognostic factors were analyzed using uni- and multivariate cox-regression method with variables scored equally in the model. p Values <.05 were considered statistically significant. RESULTS: The probability of 5- and 10-year survival was 51% (95% CI: 41-61) and 46% (95% CI: 36-56), respectively. Metastatic stage at diagnosis and tumor size ≥10 cm measured radiologically at the largest diameter were independent prognostic factors for decreased survival with significant increased hazard-risks of 3.5 (95% CI: 1.9-6.5) and 1.97 (95% CI: 1.1-3.6), respectively. DISCUSSION: In this single institution evaluation of primary appendicular HOS we found 5-and 10-year survival rates consistent with international standards for this patient group. Distant metastases and tumor size ≥10 cm at the time of diagnosis were independent prognostic factors for decreased survival in our cohort. These results underline the importance of awareness and early referral from the primary sector.
Type:
Journal article
Language:
English
Published in:
Acta Oncologica (stockholm, Sweden), 2018, Vol 57, Issue 3, p. 420-425
Keywords:
Journal Article
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2018
Scientific Level:
Scientific
ID:
2372492023

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