Retrospective analysis of clinical features and prognostic factors for pathological fracture in 39 patients with extremity osteosarcoma
10.3781/j.issn.1000-7431.2012.12.011
- Author:
Yu-Jing HUANG
1
Author Information
1. Department of Medical Oncology
- Publication Type:Journal Article
- Keywords:
COX proportional hazards regression model;
Osteosarcoma;
Pathological fracture;
Prognosis
- From:
Tumor
2012;32(12):1015-1020
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To identify the clinical features and prognostic factors in relation to extremity osteosarcoma with pathological fracture. Methods: The clinical data from 244 patients with extremity osteosarcoma between October 2003 and October 2011 were retrospectively reviewed. These patients were divided into two groups: patients with pathological fracture group and the patients without pathological fracture group. The differences in the clinical features of the two groups were analyzed. The survival analysis was performed using Kaplan-Meier method. For patients with pathological fracture, a univariate analysis (log-rank) was used to determine the prognostic factors related to the survival, and a COX proportional hazards regression model was used to identify the independent prognostic factors. Results: A higher proportion of patients with larger tumor size (P = 0.012), humeral osteosarcoma (P = 0.004) or local recurrence (P = 0.002) was observed in patients with pathological fracture. Additionally, more patients with pathological fracture received an amputation surgery, as compared with patients without pathological fracture (P = 0.032). The median survival time of patients with pathological fracture was significantly shorter than that of patients without pathological fracture (16 vs 21 months, P = 0.006). The univariate analysis showed that the significant prognosis-related factors were the tumor size, Enneking's surgical staging, KPS (Karnofsky performance status) score, cycles of adjuvant chemotherapy, local recurrence and metastasis (P < 0.05). The multivariate analysis revealed that the factors of KPS score, cycles of adjuvant chemotherapy and metastasis were the independent prognostic factors of extremity osteosarcoma with pathological fracture. Conclusion: Compared with the patients without pathological fracture, a higher proportion of patients receiving amputation surgery or having larger tumor size, humeral osteosarcoma or local recurrence was observed in patients with pathological fracture, and the prognosis of these patients was poor. The KPS score, cycles of adjuvant chemotherapy and metastasis were independent prognostic factors of extremity osteosarcoma with pathological fracture. Copyright © 2012 by TUMOR.
