Dumnoensun Pruksakorn1, Areerak Phanphaisarn2, Olarn Arpornchayanon3, Nantawat Uttamo2, Taninnit Leerapun2, Jongkolnee Settakorn4. 1. Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand; Excellence Center in Osteology Research and Training Center (ORTC), Chiang Mai University, Thailand. 2. Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand. 3. Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Thailand; Orthopedic Surgery Division, Bangkok Hospital Chiang Mai, Thailand. 4. Department of Pathology, Faculty of Medicine, Chiang Mai University, 50200, Thailand. Electronic address: jsettakorn@gmail.com.
Abstract
BACKGROUND: Osteosarcoma is a common and aggressive primary malignant bone tumor occurring in children and adolescents. It is one of the most aggressive human cancers and the most common cause of cancer-associated limb loss. As treatment in Thailand has produced a lower survival rate than in developed countries; therefore, this study identified survival rate and the poor prognostic factors of osteosarcoma in Northern Thailand. METHODS: The retrospective cases of osteosarcoma, diagnosis between 1 January 1996 and 31 December 2013, were evaluated. Five and ten year overall survival rates were analyzed using time-to-event analysis. Potential prognostic factors were identified by multivariate regression analysis. RESULTS: There were 208 newly diagnosed osteosarcomas during that period, and 144 cases met the criteria for analysis. The majority of the osteosarcoma cases (78.5%) were aged 0-24 years. The overall 5- and 10-year survival rates were 37.9% and 33.6%, respectively. Presence of metastasis at initial examination, delayed and against treatment co-operation, and axial skeletal location were identified as independent prognostic factors for survival, with hazard ratios of 4.3, 2.5 and 3.8, and 3.1, respectively. CONCLUSIONS: This osteosarcoma cohort had a relatively poor overall survival rate. The prognostic factors identified would play a critical role in modifying survival rates of osteosarcoma patients; as rapid disease recognition, a better treatment counselling, as well as improving of chemotherapeutic regimens were found to be important in improving the overall survival rate in Thailand.
BACKGROUND:Osteosarcoma is a common and aggressive primary malignant bone tumor occurring in children and adolescents. It is one of the most aggressive humancancers and the most common cause of cancer-associated limb loss. As treatment in Thailand has produced a lower survival rate than in developed countries; therefore, this study identified survival rate and the poor prognostic factors of osteosarcoma in Northern Thailand. METHODS: The retrospective cases of osteosarcoma, diagnosis between 1 January 1996 and 31 December 2013, were evaluated. Five and ten year overall survival rates were analyzed using time-to-event analysis. Potential prognostic factors were identified by multivariate regression analysis. RESULTS: There were 208 newly diagnosed osteosarcomas during that period, and 144 cases met the criteria for analysis. The majority of the osteosarcoma cases (78.5%) were aged 0-24 years. The overall 5- and 10-year survival rates were 37.9% and 33.6%, respectively. Presence of metastasis at initial examination, delayed and against treatment co-operation, and axial skeletal location were identified as independent prognostic factors for survival, with hazard ratios of 4.3, 2.5 and 3.8, and 3.1, respectively. CONCLUSIONS: This osteosarcoma cohort had a relatively poor overall survival rate. The prognostic factors identified would play a critical role in modifying survival rates of osteosarcomapatients; as rapid disease recognition, a better treatment counselling, as well as improving of chemotherapeutic regimens were found to be important in improving the overall survival rate in Thailand.
Authors: Jianping Hu; Chunlin Zhang; Kunpeng Zhu; Lei Zhang; Tao Cai; Taicheng Zhan; Xiong Luo Journal: Biomed Res Int Date: 2019-05-02 Impact factor: 3.411