Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9779-8
Annals of Surgical Oncology 15:906-914 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kim, M. S.
Right arrow Articles by Jeon, D.-G.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Kim, M. S.
Right arrow Articles by Jeon, D.-G.

Original Article

Tumor Necrosis Rate Adjusted by Tumor Volume Change Is a Better Predictor of Survival of Localized Osteosarcoma Patients

Min Suk Kim, MD1, Soo-Yong Lee, MD4, Wan Hyeong Cho, MD4, Won Seok Song, MD4, Jae-Soo Koh, MD1, Jun Ah Lee, MD3, Ji Young Yoo, MD2 and Dae-Geun Jeon, MD4

1 Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea
2 Department of Radiology, Korea Cancer Center Hospital, Seoul, Korea
3 Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
4 Department of Orthopedic Surgery, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Korea

Correspondence: Address correspondence and reprint requests to: Dae-Geun Jeon, MD; E-mail: dgjeon{at}kcch.re.kr

Background: We assessed whether new parameter that considers both tumor volume change and necrosis rate predicts metastasis-free survival of localized osteosarcoma patients. We also evaluated relationship between tumor volume change and necrosis rate or metastasis-free survival.

Methods: We retrospectively reviewed 151 patients with stage II osteosarcoma who were treated with surgery and neoadjuvant chemotherapy. The tumor volume change was measured and calculated based on pre- and postchemotherapy magnetic resonance images. The mean metastasis-free interval was 83.1 months. We calculated adjusted tumor necrosis rate as following formula: 100–(100–necrosis rate) x stchemotherapy/prechemotherapy tumor volume. Survival and logistic regression analyses were used to evaluate the correlation among size parameters, tumor necrosis rate and survival.

Results: The 5-year metastasis-free survival rate of 151 patients was 71.4% (95% CI, 67.7–75.1%). American Joint Committee on Cancer (AJCC) stage IIB (RR 2.27; 95% CI, 1.11–4.62; P = 0.025) and poor adjusted tumor necrosis rate (RR 2.02; 95% CI, 1.05–3.89; P = 0.035) independently correlated with metastasis-free survival period. Further, tumor volume change independently correlated with necrosis rate. Decreased tumor volume could predict good response, with sensitivity of 80.2%, specificity of 68.6%, and positive predictive value (PPV) of 74.7%. Increased or stable tumor volume could predict poor response, with sensitivity of 68.6%, specificity of 80.2%, and PPV of 75.0 %.

Conclusion: The necrosis rate adjusted by the tumor volume change is an independent prognostic factor in osteosarcoma. This adjusted tumor necrosis rate may serve as a basis for risk-adapted therapy in combination with other prognostic factors.

Key Words: Osteosarcoma • Histological response • Volume change • Prognosis






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.