Outcome of patients with osteosarcoma after recurrence and analysis of factors affecting the long-term survival——A long-term follow-up study of recurrent patients by multicenter
10.3760/cma.j.issn.0253-2352.2018.18.001
- VernacularTitle:骨肉瘤复发患者的转归及影响长期生存的因素分析——一项基于多中心骨肉瘤复发患者的长期随访研究
- Author:
Xiaozhou LIU
1
;
Yiyang YU
;
Xin SHI
;
Guangxin ZHOU
;
Zhiwei HE
;
Weibin ZHANG
;
Yang DONG
;
Guochuan ZHANG
;
Sujia WU
;
Yongcheng HU
;
Xiuchun YU
;
Zhen WANG
Author Information
1. 210002,中国人民解放军南京总医院骨科
- Keywords:
Osteosarcoma;
Recurrence;
Prognosis;
Root cause analysis
- From:
Chinese Journal of Orthopaedics
2018;38(18):1089-1096
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the outcome and affecting factors of patients with osteosarcoma after recurrence.Methods Retrospective analysis was used to analyze the achieved data and prognosis-related factors of 72 patients with extremity osteosarcoma after recurrence from June 2000 to September 2012 through multicenter joint treatment.37 males and 35 females were included.The overall age was 7 to 61 years old (average age22.2 years old).Classification based on the tumor recurrent parts:42 cases (58.3％) on femur,18 cases (25％) on tibia,7 cases (9.7％) on humerus and 5 cases (6.9％) on fibula.Classification based on metastases:14 cases of simple recurrence (19.4％),58 cases (80.6％) of recurrence with metastasis:29 cases (40.3％) of recurrence occurred first,9 cases (12.5％) of metastasis occurred firstly,20 cases (27.8％) of simultaneous recurrence with metastasis;12/14 patients (16.7％) of simple recurrence had long-term survival,but 2 died (2.8％).Six of 58 patients (8.3％) of recurrence with metastasis had long-term survival but 52 died (72.2％).Results The overall 10-year postrelapse survival rate of the 72 patients was 25％.Kaplan-Meier univariate analysis revealed that postrelapse survival was significantly influenced by the continued treatment after recurrence and the number of postoperative chemotherapy,but it was not significantlyinfluenced by age,gender and the number of preoperative chemotherapy.Multivariate analysis revealed that the continued treatment after recurrence and the number of postoperative chemotherapy were independent prognostic factors (P=0.002,P=0.007).At the same time,according to the survival curve grouped by different indicators,the number of chemotherapy after recurrence has no significant effect on TFS.However,the continued treatment after recurrence has obvious statistical significance on improving TFS and OS of patients (P=0.026,P=0.002).Conclusion Resection and standard postoperative chemotherapy had significant effects on the postrelapse survival in patients with osteosarcoma.There are good prospects for further multimodal therapy and multicenter cooperation for osteosarcoma after recurrence.
