Liliana Vasquez1,2, Jose Silva3, Sharon Chavez4, Arturo Zapata4, Rosdali Diaz4, Fanny Tarrillo1, Ivan Maza1, Luis Sialer3, Juan García4. 1. Pediatric Oncology Unit, Edgardo Rebagliati Martins Hospital, Lima, Peru. 2. Universidad de San Martín de Porres, Centro de Investigación de Medicina de Precisión, Lima, Peru. 3. Orthopedic Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru. 4. Pediatric Oncology, National Institute of Neoplastic Diseases, Lima, Peru.
Abstract
BACKGROUND: The aim of this study is to evaluate the relationship between the latency to diagnosis (LD) and the time to completion of chemotherapy (TCC) with clinical outcomes in children with osteosarcoma. METHODS: We performed a retrospective analysis of all patients who received treatment for osteosarcoma in two tertiary centers in Peru from 2008 to 2015. All causes of delayed LD or TCC were evaluated. Overall survival (OS) and event-free-survival (EFS) were estimated and compared according to LD, TCC, and established clinical prognostic factors. RESULTS: One hundred and thirteen patients were included in the study. The median LD was 13.5 weeks (interquartile range, 10-18.5 weeks). No association was observed among clinical stage, tumor size, and LD. Delayed LD was not associated with a worse clinical outcome. Multivariate analysis confirmed that OS and EFS were significantly worse in cases of a delayed TCC (≥4 weeks), with hazard ratios of 2.70 (1.11-6.76, P = 0.003) and 1.13 (1.00-1.26, P = 0.016), respectively. Most delays in TCC (85%) were due to extramedical reasons (e.g., lack of available hospital beds). CONCLUSION: The LD did not seem to influence the EFS and OS in pediatric patients with osteosarcoma. However, a delay in TCC from any cause is independently associated with poor outcome in pediatric patients with osteosarcoma. Based on these results, further efforts may be needed to avoid treatment delays in patients with osteosarcoma in middle-income countries.
BACKGROUND: The aim of this study is to evaluate the relationship between the latency to diagnosis (LD) and the time to completion of chemotherapy (TCC) with clinical outcomes in children with osteosarcoma. METHODS: We performed a retrospective analysis of all patients who received treatment for osteosarcoma in two tertiary centers in Peru from 2008 to 2015. All causes of delayed LD or TCC were evaluated. Overall survival (OS) and event-free-survival (EFS) were estimated and compared according to LD, TCC, and established clinical prognostic factors. RESULTS: One hundred and thirteen patients were included in the study. The median LD was 13.5 weeks (interquartile range, 10-18.5 weeks). No association was observed among clinical stage, tumor size, and LD. Delayed LD was not associated with a worse clinical outcome. Multivariate analysis confirmed that OS and EFS were significantly worse in cases of a delayed TCC (≥4 weeks), with hazard ratios of 2.70 (1.11-6.76, P = 0.003) and 1.13 (1.00-1.26, P = 0.016), respectively. Most delays in TCC (85%) were due to extramedical reasons (e.g., lack of available hospital beds). CONCLUSION: The LD did not seem to influence the EFS and OS in pediatric patients with osteosarcoma. However, a delay in TCC from any cause is independently associated with poor outcome in pediatric patients with osteosarcoma. Based on these results, further efforts may be needed to avoid treatment delays in patients with osteosarcoma in middle-income countries.
Authors: Denise Willmer; Stefan K Zöllner; Frieder Schaumburg; Heribert Jürgens; Thomas Lehrnbecher; Andreas H Groll Journal: Cancers (Basel) Date: 2021-04-21 Impact factor: 6.639
Authors: Michael D Eckhoff; Matthew E Wells; Osvaldo Padilla; Elizabeth M Polfer; Christopher J Castagno; Ahmed M Thabet; Shaimaa Elzamly; Harry L Wilson; Rajiv Rajani Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-10-13