Prognostic factors in 43 cases of osteosarcoma.

Osteosarcoma is the most common primary bone malignancy. The purpose of this study was to investigate the prognostic factors in the overall and disease-free survival rates by using univariate methods and Cox's multivariate regression model. Patients from Tri-Service General Hospital and Chang Gung Memorial Hospital in Kaohsiung with pathologically proven high-grade osteosarcoma were recruited for this study. There were 29 (67.4%) men and 14 (32.6%) women with a mean age of 17.8 years (range 8 to 35 years). Twenty-five cases (58.1%) were stage IIB, and 18 cases (41.9%) were stage III. The overall five-year survival rate was 15% for these 43 cases. Additionally, the disease-free survival rate was 20% at five years for the 25 stage IIB cases. Univariate and multivariate analyses showed that male gender, stage III disease, surgery only, radiotherapy only, chemotherapy only, no treatment and proximal extremity location were the unfavorable factors associated with death in these 43 cases; while male gender, radiotherapy only, chemotherapy only, no treatment and an elevated serum alkaline phosphatase level were the unfavorable factors associated with recurrence for stage IIB cases.