Prognosis analysis of 44 patients with extremity osteosarcoma

Objective To investigate the survival of patients with osteosarcoma treated in a single institute. Methods A total of 44 patients with osteosarcoma who had undergone surgical treatment in the Second Hospital of Shanxi Medical University from January 2013 to January 2018 were enrolled in this retrospective study. After the diagnosis of osteosarcoma, patients received cisplatin plus doxorubicin neoadjuvant chemotherapy. The patient's basic data, auxiliary examination results, surgical methods, pathological reports, prognosis and other information were reviewed and recorded, and the Kaplan-Meier method, Cox regression model were used to analyze the relationship between various factors and prognosis of patients. Results Among 44 patients, there were 23 males and 21 females, aged from 7 to 62 years old (average 27.2 years old); the tumor site of 5 cases was located at the upper limbs and 39 was located at the lower limbs; the diameter of the tumor was < 10 cm in 30 cases, ≥10 cm in 14 cases. All patients underwent extensive resection, including 35 cases of limb salvage surgery and 9 cases of amputation. At the end of follow-up, the 3-year overall survival rate was 65.5%. The 3-year overall survival rates in patients with or without local recurrence were 40.0% and 72.4%, respectively (P = 0.037). The 3-year overall survival rates in patients with or without lung metastasis were 32.0% and 84.5%, respectively (P < 0.01). The 3-year overall survival rates in patients with tumor's diameter≥10 cm or <10 cm were 40.2% and 78.1%, respectively (P = 0.003). The 3-year overall survival rates in patients with or without standard chemotherapy were 74.9% and 35.8%, respectively (P = 0.048). The 3-year overall survival rates in patients with high or normal lactate dehydrogenase at the time of diagnosis were 38.1% and 72.3%, respectively (P = 0.010). Multivariate analysis showed that standard chemotherapy (P = 0.005) and lung metastasis (P = 0.003) were independent prognostic factors affecting the survival of patients with osteosarcoma. Conclusions Neoadjuvant chemotherapy combined with surgical methods can improve the survival rate of patients with osteosarcoma of the extremities. Nonstandard chemotherapy and lung metastasis during or after treatment affect the survival of patients with osteosarcoma. Key words: Osteosarcoma; Chemotherapy, adjuvant; Prognosis; Neoplasm metastasis