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Clinical significance of indeterminate pulmonary nodules on the survival of 364 patients with nonmetastatic, high‐grade, localized osteosarcoma: A 12‐year retrospective cohort study
Author(s) -
Zhou Chenliang,
Wang Yiyun,
Qian Guowei,
Li Hongtao,
Yu Wenxi,
Shen Zan,
Zheng Shuier,
Wang Yonggang
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26316
Subject(s) - medicine , confidence interval , osteosarcoma , hazard ratio , retrospective cohort study , cohort , overall survival , multivariate analysis , proportional hazards model , pathology
Background and Objectives We investigated the clinical significance of indeterminate pulmonary nodules (IPNs) in patients diagnosed with nonmetastatic, high‐grade localized osteosarcoma. Methods We retrospectively analyzed the clinical data of 364 patients with nonmetastatic, high‐grade localized osteosarcoma. Based on pulmonary computed tomography findings at presentation, the patients were categorized into the no‐nodules and the IPNs group and were further categorized into subgroups based on age (<18 and ≥18 years). We performed an intergroup comparison of event‐free survival (EFS) and overall survival (OS). Results At presentation, 276 (75.8%) patients showed no nodules, and 88 (24.2%) patients showed IPNs. The EFS and OS were similar between adults with IPNs ( n = 54 [30.5%]) and without nodules ( n = 123 [69.5%]) ( p = .200 and p = .609, respectively). No significant intergroup difference in OS was observed in pediatric patients ( p = .093). However, pediatric patients with IPNs ( n = 34 [18.2%]) had poorer EFS than those without nodules ( n = 153 [81.8%]) ( p = .016). Multivariate analyses confirmed that IPNs were independently associated with poorer EFS in pediatric patients (hazard ratio 1.788, 95% confidence interval 1.092–2.926, p = .021). Conclusions This study showed that IPNs at presentation did not affect the survival of adults with nonmetastatic, high‐grade localized osteosarcoma but were associated with poorer EFS in pediatric patients.