Retrospective analysis of clinical characteristics and prognosis of 30 patients misdiagnosed and mistreated for osteosarcoma
10.3781/j.issn.1000-7431.2012.08.010
- Author:
Guang-Lei QIAO
1
Author Information
1. Department of Medical Oncology
- Publication Type:Journal Article
- Keywords:
Diagnostic errors;
Osteosarcoma;
Prognosis;
Therapeutic errors
- From:
Tumor
2012;32(8):622-627
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the clinical characteristics and prognosis between the misdiagnosed and mistreated patients and the correctly diagnosed and treated patients with osteosarcoma. Methods: The clinical records of patients with osteosarcoma who received misdiagnosis and unplanned therapy (n = 30) and those who received correct diagnosis and therapy (n = 60) between January 2007 and February 2010 were retrospectively reviewed. The follow-up time was 6-60 months. The factors including gender, age, tumor location, Enneking's surgical staging, Karnofsky performance status score, pathological type, surgical procedure, tumor size, tumor necrosis rate, frequency of adjuvant chemotherapy, local recurrence rate, and lung metastasis rate were compared between the two groups. The two-year survival rate was calculated by Kaplan-Meier method. Results: No significant differences between the two groups were found in terms of gender, Enneking's surgical staging, Karnofsky performance status score, tumor location, pathological type, surgical procedure, frequency of adjuvant chemotherapy, time to local recurrence and time to lung metastasis (P > 0.05). The proportions of patients aged 30 years or more (46.7% vs 11.7%, P < 0.001), having a tumor's diameter of 10 cm or more (50.0% vs 23.3%, P = 0.011), and having tumor necrosis rate lower than 90.0% (80.0% vs 60.0%, P = 0.016) were significantly higher in the misdiagnosed and mistreated group than in the correctly diagnosed and treated group. The local recurrence rate (33.3% vs 10.0%, P = 0.006) and the lung metastasis rate (63.3% vs 43.3%, P = 0.037) in the misdiagnosed and mistreated group were also significantly higher than those in the correctly diagnosed and treated group. The median survival time and the two-year survival rates of the misdiagnosed and mistreated group and the correctly diagnosed and treated group were 25.5 (95% confidence interval: 7.1-58.9) months and 38.0 (95% confidence interval: 12.2-55.0) months, and 83.3% and 63.3%, respectively (P = 0.025; P = 0.036). Conclusion: The patients with osteosarcoma aged 30 years or more were more likely misdiagnosed as having benign diseases. Misdiagnosis and unplanned therapy for osteosarcoma can result in higher local recurrence rate and lung metastasis rate as well as a poor prognosis. Copyright © 2012 by TUMOR.
