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Tumor size as a predictor of outcome in pediatric non‐metastatic osteosarcoma of the extremity
Author(s) -
Kaste Sue C.,
Liu T.,
Billups C.A.,
Daw N.C.,
Pratt C.B.,
Meyer W.H.
Publication year - 2004
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20077
Subject(s) - medicine , osteosarcoma , sample size determination , predictive value , continuous variable , radiology , oncology , surgery , pathology , statistics , mathematics
Background Better predictors of outcome would allow improved risk‐adapted therapy for pediatric nonmetastatic osteosarcoma of the extremity. We investigated the predictive value of MR imaging‐based measures of absolute and relative tumor size and volume at the time of diagnosis. We also assessed the relation of tumor size to age and histologic response. Methods We retrospectively abstracted demographic, treatment history, and outcome information of patients treated on a single institutional protocol. A single pediatric oncologic radiologist manually measured each primary lesion and the affected native bone in three dimensions on MR images obtained at the time of diagnosis. Eight parameters of tumor size were analyzed for their value in predicting overall survival (OS) and event‐free survival (EFS). Results The median age of the 42 patients was 13.5 years (range: 5.9–18.7 years); 50% were female and 74% were Caucasian. Absolute tumor volume was an important predictor of OS ( P < 0.05); absolute tumor depth (analyzed as a continuous variable) was a significant predictor of OS ( P = 0.018) and EFS ( P = 0.036). Relative measures of tumor size were not found to predict outcome. No relation was seen between tumor size and histologic response. Conclusions Absolute tumor size at the time of diagnosis is significantly predictive of OS and EFS. If validated in a larger study, this indicator should be used in the design of risk‐adapted treatment protocols for osteosarcoma. © 2004 Wiley‐Liss, Inc.