Premium
Relative tumor burden predicts metastasis‐free survival in pediatric osteosarcoma
Author(s) -
Lee Jun Ah,
Kim Min Suk,
Kim Dong Ho,
Lim Jung Sub,
Yoo Ji Young,
Koh Jae Soo,
Lee SooYong,
Jeon DaeGeun,
Park Kyung Duk
Publication year - 2008
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.21446
Subject(s) - medicine , osteosarcoma , relative risk , body surface area , overall survival , metastasis , relative survival , distant metastasis , nuclear medicine , oncology , pathology , cancer , confidence interval , cancer registry
Background To analyze the significance of relative tumor burden in pediatric osteosarcoma. Methods We retrospectively reviewed 241 patients with localized pediatric osteosarcoma and measured tumor size on MR images at presentation. Absolute tumor size parameters measured on MR images were converted to relative values by dividing body surface area. Both absolute and relative size parameters were analyzed for their correlation with metastasis‐free survival (MFS). Results The 5‐year MFS was 67.5 ± 3.1%, with median follow‐up of 72 months (range, 8–205 months). In addition to poor histologic response (RR 3.24; 95% CI: 1.99–5.28; P < 0.001), large relative tumor plane (RTP; RR 3.28; 95% CI: 1.72–6.25; P < 0.001), large relative tumor area (RTA; RR 4.14; 95% CI: 1.53–11.22; P = 0.005), and large absolute tumor width (ATW; RR; 3.10; 95% CI: 1.23–7.79; P = 0.02) shortened the MFS. When survival was analyzed by combining RTP and histologic response, patients with small RTP and a good response showed the best survival (5‐year MFS of 90.2 ± 3.6%), while those with large RTP and a poor response showed the worst survival (5‐year MFS of 45.1 ± 6.6%). Conclusion Relative two‐dimensional tumor size parameters (RTP and RTA) rather than absolute values are useful prognostic factors in pediatric osteosarcoma patients. © 2007 Wiley‐Liss, Inc.